The degree of oxidative stress is associated with major adverse effects after lung resection: A prospective study

Misthos, Panagiotis; Katsaragakis, Stylianos; Theodorou, Dimitrios; Milingos, Nikolaos; Skottis, Ion

doi:10.1016/j.ejcts.2005.12.027

Cited by 107 publications

(67 citation statements)

References 19 publications

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“…more dangerous in patients with pre-existing pulmonary disease. Other well-known side-effects of GA and one-lung ventilation include-but are not limited to-induction of cardiac arrhythmias (16), transient hypoxemia, injury to liver and kidney, cognitive deterioration, and impairment in perioperative immunosurveillance (17). Mechanical airway injury secondary to double-lumen tube insertion should be also taken into account, even though the estimated incidence of airway laceration is extremely low (18).…”

Section: Review Articlementioning

confidence: 99%

Non-intubated video-assisted thoracic surgery: where does evidence stand?

Tacconi¹,

Pompeo²

2016

J. Thorac. Dis.

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In recent years, non-intubated video-assisted thoracic surgery (NIVATS) strategies are gaining popularity worldwide. The main goal of this surgical practice is to achieve an overall improvement of patients' management and outcome thanks to the avoidance of side-effects related to general anesthesia (GA) and one-lung ventilation. The spectrum of expected benefits is multifaceted and includes reduced postoperative morbidity, faster discharge, decreased hospital costs and a globally reduced perturbation of patients' well-being status. We have conducted a literature search to evaluate the available evidence on this topic. Meta-analysis of collected results was also done where appropriate. Despite some fragmentation of data and potential biases, the available data suggest that NIVATS operations can reduce operative morbidity and hospital stay when compared to equipollent procedures performed under GA. Larger, well designed prospective studies are thus warranted to assess the effectiveness of NIVATS as far as to investigate comprehensively the various outcomes. Multi-institutional and multidisciplinary cooperation will be welcome to establish uniform study protocols and to help address the questions that are to be answered yet.Keywords: Non-intubated thoracic surgery; video-assisted thoracic surgery (VATS); awake VATS; regional more dangerous in patients with pre-existing pulmonary disease. Other well-known side-effects of GA and one-lung ventilation include-but are not limited to-induction of cardiac arrhythmias (16), transient hypoxemia, injury to liver and kidney, cognitive deterioration, and impairment in perioperative immunosurveillance (17). Mechanical airway injury secondary to double-lumen tube insertion should be also taken into account, even though the estimated incidence of airway laceration is extremely low (18).The rationale of NIVATS is that avoidance of one-lung ventilation may help achieve a reduction in perioperative morbidity, particularly in subjects with poor cardiorespiratory performance. Accordingly, it is not surprising that most of the earliest NIVATS experiences consisted of small caseseries dealing with management of patients with chronic respiratory failure or other comorbidity.A paradigm shift is-however-being observed more recently and in some centers, adoption of NIVATS is being progressively extended to patients without any substantial risk factor for GA and one-lung ventilation.Indeed, in a recent survey from the European Society of Thoracic Surgeons, 70% of responders believed that ideal candidates for NIVATS are patients with multiple comorbidities although it is worth noting that 20% of them affirmed to be also favorable to the use of NIVATS regardless of patients ' comorbidity profile (19). This strategy appears to be justified when taking into account benefits other than protection from postoperative complications, which include reduced hospital stay, better quality of recovery and lower procedure-related costs. Furthermore, a lesser perturbation of immune and endocrine s...

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Section: Review Articlementioning

confidence: 99%

Non-intubated video-assisted thoracic surgery: where does evidence stand?

Tacconi¹,

Pompeo²

2016

J. Thorac. Dis.

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“…sonucu, günümüzde hipoksemi sıklığı ciddi oranda azalmıştır. Üstelik son yıllarda yüksek TV ile ventile olan akciğerdeki enflamasyon ilişkisi gerek deneysel, gerekse klinik çalışmalarda gösterilmekte-dir (12)(13)(14)(15) . Çift akciğerdekine benzer TV'lerin uygulandığı geleneksel TAV stratejisi ile akciğer mekaniğin-de bozulma, ağırlık artışı ve pulmoner hipertansiyon gelişimi saptanmıştır (13,16) .…”

Section: Discussionunclassified

Effects of Lower Tidal Volumes on Oxygenation During One-Lung Ventilation

Ulke¹,

Kose²,

Çamcı³

et al. 2011

GKDA Derg

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“…33 Prolonged OLV ([ 120 min) and generation of oxidative stress have been associated with increased rates of respiratory failure, cardiac arrhythmias, and pulmonary hypertension. 34 Moreover, high F I O 2 can lead to absorption atelectasis in poorly ventilated lung regions when oxygen absorption in denitrogenated alveoli results in alveolar collapse.…”

Section: Inspired Oxygen Fractionmentioning

confidence: 99%

“…33 Une VUP prolongée ([ 120 min) et la génération de stress oxydatif ont été associées à des taux accrus d'insuffisance respiratoire, d'arythmies cardiaques et d'hypertension pulmonaire. 34 De plus, une F I O 2 élevée peut provoquer une atélectasie d'absorption dans les régions pulmonaires mal ventilées lorsque l'absorption d'oxygène dans les alvéoles dénitrogénées entraîne un collapsus alvéolaire.…”

Section: Fraction D'oxygène Inspiréunclassified