Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood

Abstract

During lung lobectomy, the operated lung is collapsed and oxidative injury occurs, with the levels of markers of oxidative stress increasing simultaneously in exhaled breath condensate and blood during one-lung ventilation. These increases were larger after resuming two-lung ventilation. Increases immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation were directly correlated with the duration of one-lung ventilation.

Remote ischaemic preconditioning of the lung: from bench to bedside—are we there yet?

“…Garcíade-la-Asunción et al choose the oxidative stress marker 8-isoprostane in exhaled breath condensate (EBC) as primary outcome parameter. Measuring oxidative stress parameters directly in the EBC and blood is of special interest as it has been shown that the duration of the lung collapse in lobectomy is directly related to an increase of those markers (18)…”

“…García-de-la-Asunción et al based there sample size analysis on a previously published article in which also 8-isoprostane was measured in EBC (18). Based on these former results, the sample size of 28 patients per group, which was initially aimed for, seems to be reasonable.…”

Recommendations for perioperative management of lung cancer patients with comorbidities

“…One-lung ventilation is usually used for minimally invasive surgery, but could increase the risk of acute lung injury [11]. …”

Exhaled Breath Condensate Acidification Occurs During Surgery for Abdominal Cancer

“…Both EBC and blood showed significant increases in oxidative stress markers. These results may explain the acute lung injury that occurs after pulmonary lobectomy (9). In their study concerning individuals undergoing either coronary artery bypass grafting (CABG) or lobectomy for lung cancer, Moloney et al collected EBC in endotracheally intubated patients at the beginning and at the end of CABG, as well as of lobectomy (8).…”

“…outcome or to guide therapeutic interventions (1)(2)(3)(4)(5)(6). Collection of EBC is a simple, non-invasive and safe procedure that has been used in actively participating individuals breathing on their own, as well as in mechanically-ventilated patients, for studying the composition of airway lining fluid and to detect lung inflammation (7)(8)(9). However, issues of standardization and several technical aspects limit its application in everyday clinical practice (10).…”