Perioperative use of lung protective ventilation strategy on immune function in patients undergoing thoracoscopic radical resection of lung cancer / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the lung protective ventilation strategy on immune function in patients undergoing radical resection of lung cancer.Methods Sixty patients undergoing thoracoscopic radical resection of lung cancer, 47 males and 13 females, aged 35-64 years, BMI 18-29 kg/m2, falling into ASA physical statusⅠ orⅡ, were randomly divided into 2 groups with 30 cases in eachconventional mechanical ventilation (group C), protective mechanical ventilation group (group P).Volume-controlled ventilation was performed in the 2 groups.Protective mechanical ventilation mode was setted up as followstidal volume (VT) 8 ml/kg and respiratory rate (RR) 12-14 breaths/min during two-lung ventilation (TLV) ;VT 6 ml/kg, PEEP 5 cm H2O and RR 14-16 breaths/min during one-lung ventilation (OLV).Before induction of anesthesia (T0), at the end of surgery (T1), 24 hafter surgery (T2), 72 hafter surgery (T3), blood samples were taken from the central venous for determination of peripheral T lymphocyte subsets CD3+, CD4+, CD8+ and NK cell.The CD4+/CD8+ratio was also calculated.Results Compared with T0, the percentage of CD3+, CD4+, NK cell and the CD4+/CD8+ratio was significantly decreased at T1 and T2 in both groups (P<0.05).Compared with group P, the percentage of CD3+, CD4+, NK cell and the CD4+/CD8+ratio was significantly lower in the group C at T1 and T2 (P<0.05).Compared with T0, there was no significant difference at T3 with respect of the percentage of CD3+, CD4+, NK cell and the CD4+/CD8+ratio in the group P while those parameters still lower at T3 in the group C (P<0.05).Conclusion Perioperative use of lung protective ventilation strategy could not only alleviate the immune suppression but also make the immune function recover faster in patients undergoing thoracoscopic elective radical resection of lung cancer.