Antiinflammatory effect of sevoflurane in open lung surgery with one-lung ventilation

Potočnik, Igor; Jankovic, Novak V.; Šoštarič, Maja; Jerin, Aleš; Štupnik, Tomaž; Skitek, Milan; Markovič-Božič, Jasmina; Klokočovnik, Tomislav

doi:10.3325/cmj.2014.55.628

Cited by 29 publications

(42 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These inflammatory mediators were released in the blood through the pulmonary circulation, and caused multiple organ dysfunction or failure. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery

Zhang

Tian

et al. 2018

Medicine

View full text Add to dashboard Cite

The objective of the present study was to explore the effects of different one-lung ventilation (OLV) modes on lung function in elderly patients undergoing esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA Grades I–II, with OLV indications) undergoing elective surgery were recruited in the study. Patients were randomly divided into 4 groups (n = 45). In Group A, patients received low tidal volume (VT < 8 mL/kg) + pressure controlled ventilation (PCV), low tidal volume (VT < 8 mL/kg) + volume-controlled ventilation (VCV) in Group B, high tidal volume (VT ≥ 8 mL/kg) + PCV in Group C and high tidal volume (VT ≥ 8 mL/kg) + VCV in Group D. Two-lung ventilation involved routine tidal volume (8–10 mL/kg) at a frequency of 12 to 18 times/min, and VCV mode. Clinical efficacy among 4 groups was compared. The partial pressure of end-tidal carbon dioxide (PetCO2) did not significantly differ among 4 groups (all P > .05), and the oxygenation index and SO2 in Group A were significantly higher than in the other groups (P < .05). The PetCO2, peak airway pressure (Ppeak), platform airway pressure (Pplat), and mean airway pressure (Pmean) in Group A were significantly lower than those in the other groups (all P < .05). However, airway resistance (Raw) among 4 groups did not significantly differ (all P > .05). The incidence of pulmonary infection, anastomotic fistula, ventilator-induced lung injury, lung dysfunction, difficulty weaning from mechanical ventilation, and multiple organ dysfunction in Groups A and B were lower than that in Groups C and D (all P < .05). The expression levels of IL-6, tumor necrosis factor-α, and C-reactive protein in lavage fluid in Group A were significantly lower than those in the other groups (all P < .05). OLV with low tidal volume (VT < 8 mL/kg) + PCV (5 cmH2O PEEP) improved lung function and mitigated inflammatory responses in elderly patients undergoing esophageal cancer surgery.

show abstract

“…These inflammatory mediators were released in the blood through the pulmonary circulation, and caused multiple organ dysfunction or failure. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery

Zhang

Tian

et al. 2018

Medicine

View full text Add to dashboard Cite

show abstract

“…During tube application, the lung is in a collapsed state. Although it is beneficial for surgical operation, OLV can cause lung collapse, which in turn leads to increased intrahepatic shunt, hypoxia and high airway pressure in the healthy lung, causing different degrees of lung injury later ( 16 , 17 ). In this study, the controlled lung collapse based on the previous study on lung injury was proposed for the first time.…”

Section: Discussionmentioning

confidence: 99%

Correlation between controlled lung collapse and early lung injury in dogs

Liu

Wang

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

A new type of pulmonary sequestration ventilator was used to compare the relationship between controlled lung collapse and early lung injury in thoracic surgery for dogs. Eighteen experimental dogs were randomly divided into three groups (G1-G3 groups). After general anesthesia, the shunt balance in lung was controlled and the pulmonary sequestration tube was placed in the femoral artery and vein, and the Swan-Ganz tube was placed into the right internal jugular vein as well. Two-lung ventilation (TLV) was first performed for 20 min, followed by one-lung ventilation (OLV). The degree of collapse was 100% (G1), 90% (G2), and 50% (G3). Blood samples were extracted from femoral artery and jugular vein prior to collapse (T0), and at 30 (T1), 60 (T2), and 120 (T3) min after collapse for blood gas analysis to determine the shunt ratio (Qs/Qt). Blood samples were also subjected to enzyme linked immunosorbent assay (ELISA) to determine serum tumor necrosis factor-α (TNF-α), intercellular immune adhesion molecule-1 (ICAM-1) and interleukin-6 (IL-6) levels. Arterial blood pressure, heart rate, pulmonary artery pressure and other physiological indicators were monitored during the experiment. Lung tissues were collected at T3 to calculate the wet/dry weight ratio (W/D). Histopathological changes were observed and compared by microscopic observation and blind scoring of pathological section after hematoxylin and eosin (H&E) staining. There were no significant differences in the physiological indexes between the two groups during TLV (P>0.05). Mean pulmonary arterial pressure (MPAP) in G2 and G3 groups was significantly more stable than that in G1 group after OLV (P<0.05); shunt ratio Qs/Qt, W/D, and serum TNF-α, ICAM-1 and IL-6 levels in the lung were decreased; and the degrees of pulmonary edema, hemorrhage, inflammatory cell infiltration and lung injury were also decreased. There was no statistically significant difference in each index at each time-point between G2 and G3 groups (P>0.05). Compared with complete lung collapse (collapse degree: 100%), controlled lung collapse (collapse degree: 90% and 50%) can better reduce the intraoperative lung injury, but there was no significant difference between the collapse degrees of 90 and 50%.

show abstract

“…Some clinical researches have investigated the pulmonary inflammatory-modulating effects of sevoflurane and propofol during OLV. Their results suggested that sevoflurane suppressed the local alveolar inflammatory responses and reduced inflammatory mediators release in patients undergoing OLV, resulting in better clinical outcomes in thoracic surgery [ 13 , 21 , 22 ]. A recent meta-analysis by Sun et al also showed that inhalational anesthetics might be preferable for OLV during thoracic anesthesia due to their protective effects of attenuating inflammatory responses when compared with propofol-based intravenous anesthesia [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of sevoflurane and propofol on the development of pneumonia after esophagectomy: a retrospective cohort study

Zhang

Wang

2017

BMC Anesthesiol

View full text Add to dashboard Cite

BackgroundPostoperative pneumonia (PP) is one of the common complications following esophagectomy and associated with poor short- and long-term outcomes. Sevoflurane and propofol, which have inflammatory-modulating effects, are common used general anesthetics. This study aimed to compare the effects of anesthesia with sevoflurane and propofol on the development of PP after esophageal surgery for cancer.MethodsThe electronic medical records of patients who underwent elective esophagectomy between July 2013 and July 2016 were reviewed. We conducted univariate and multivariate logistics analysis and propensity score matching analysis to compare the effect of sevoflurane and propofol on the incidence of PP and to identify the risk factors for PP after esophagectomy.ResultsOverall, the incidence of postoperative pneumonia was 9.5%. There was no significant difference in the rates of PP between sevoflurane group and propofol group either before or after propensity score matching (9.6% vs 8.0%, P = 0.606; 7.7% vs 6.4%, P = 0.754, respectively). Univariate and multivariate analysis revealed that alcohol use (OR 1.513; 95% CI 1.062–2.156), surgical procedure (Sweet: referent; Ivor-Lewis: OR 1.993; 95% CI 1.190–3.337; Three-incision: OR 1.878; 95% CI 1.296–2.722) and surgeon experience (high-volume: referent; low-volume: OR 1.525; 95% CI 1.090–2.135) were significant risk factors of postoperative pneumonia.ConclusionsSevoflurane did not differ from propofol in terms of affecting the risk of PP development after esophagectomy.

show abstract

Antiinflammatory effect of sevoflurane in open lung surgery with one-lung ventilation

Cited by 29 publications

References 27 publications

The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery

The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery

Correlation between controlled lung collapse and early lung injury in dogs

Effects of sevoflurane and propofol on the development of pneumonia after esophagectomy: a retrospective cohort study

Contact Info

Product

Resources

About