Effect of permissive hypercapnia on pulmonary function and inflammatory response of the collapsed lung / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the effect of permissive hypercapnia on pulmonary function and in-flammatory responses of the collapsed lung of patients underwent video-assisted pulmonary lobectomy after one-lung ventilation.Methods Fifty patients,aged 38-65 years,ASA Ⅱ or Ⅲ,including 30 males and 20 females,scheduled for video-assisted pulmonary lobectomy were selected and divided into two groups ran-domly,with 25 patients in each group.During the surgery,PaCO2 of patients in group C were maintained during 35 to 45 mm Hg,while in group H the value were 55 to 65 mm Hg.The arterial blood samples were collected at 1 min before one-lung ventilate (T1 ),30 min after one-lung ventilate (T2 )and 30 min after re-flow of the collapsed lung (T3 )for arterial blood gas analysis,then the respiratory index of each patient was evaluated.Peripheral venous blood and bronchoalveolar lavage fluid draw from left lower lobar of the col-lapsed lung were collected to evaluate the levels of TNF-α,IL-6,and IL-10 at T1 ,T2 and T3 .The peak in-spiratory pressure,plateau pressure and tidal volume were also recorded to calculate lung dynamic compli-ance.Results Compared to group C,peak inspiratory pressure of group H was significantly higher;the IL-10 level of bronchoalveolar lavage fluid of the collapsed lung and the pulmonary dynamic compliance of group H were significantly higher at T2 and T3 ,and the concentrations of TNF-α,IL-6 of bronchoalveolar lavage fluid,the peak pressure,and respiratory index of group H were lower significantly at the same point of time (P <0.05).Conclusion Permissive hypercapnia would inhibit inflammation response of collapsed lung after one-lung ventilation effectively,improve lung diffusion capacity and pulmonary compliance.