Effect of extremity ischemic preconditioning on expression of aquaporin 1 in lung tissues of patients undergoing pulmonary lobectomy / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of extremity ischemic preconditioning on the expression of aquaporin 1 (AQP1) in the lung tissues of patients undergoing pulmonary lobectomy.Methods Forty-six American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 30-64 yr,weighing 50-80 kg,scheduled for elective pulmonary lobectomy performed via a thoracoscope,were randomly divided into 2 groups (n =23 each) using a random number tablecontrol group (group C) and extremity ischemic preconditioning group (group R).After induction of anesthesia,the patients were intubated with the double-lumen tube.Correct position of the tube was verified with the fiberoptic bronchoscope.In group R,ischemic preconditioning was induced by 3 cycles of 5-min lower extremity ischemia followed by 5-min reperfusion after induction of anesthesia.Lung tissues were obtained when the lobe of the lung was removed during surgery for determination of AQP1 expression (by Western blot) and wet/dry lung weight ratio and for microscopic examination of pathologic changes which were scored.Immediately after onset of one-lung ventilation,at 30 and 60 min of one-lung ventilation,and at 1 h after restoration of two-lung ventilation,arterial blood samples were collected for blood gas analysis,and the oxygenation index was calculated.The development of postoperative complications and length of postoperative hospital stay were recorded.Results Compared with group C,the expression of AQP1 was significantly up-regulated,and oxygenation index at 30 and 60 min of one-lung ventilation and 1 h after restoration of two-lung ventilation were significantly increased,the pathologic score,the wet/dry lung weight ratio and incidence of postoperative pneumonia and atelectasis were significantly decreased,and the length of postoperative hospital stay was significantly shortened in group R (P＜ 0.05).Conclusion Extremity ischemic preconditioning can reduce lung injury through up-regulating AQP1 expression in the patients undergoing pulmonary lobectomy.