Protective effect of apneic oxygen insufflation on operated lung of patients undergoing one-lung ventilation / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the protective effect of apneic oxygen insufflation on the operated lung of patients undergoing one-lung ventilation (OLV).Methods Fifty-four American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 50-75 yr,scheduled for elective pulmonary tumorectomy,were divided into 2 groups using a random number table method:conventional group (group C,n=27) and apneic oxygen insufflation group (group A,n=27).The patients were intubated with a double-lumen tube after induction of anesthesia.Apneic oxygen insufflation was performed on the operated lung immediately after OLV by continuously administrating oxygen at 5 L/min with inspiratory oxygen fraction of 100％.Blood samples were taken from the radial artery at 1 min before OLV (T1) and 3 and 33 min after OLV (T2,3) for blood gas analysis,pulmonary oxygenation index and intrapulmonary shunt rate were calculated,and the occurrence of oxygen index less than 200 and 300 mmHg was recorded.Blood samples of the internal jugular vein were collected to detect the concentrations of surfactant protein B (SPB) and surfactant protein C (SP-C) in serum.The lung on the operated side was lavaged at T3,and the broncho-alveolar lavage fluid was collected for determination of the concentrations of SP-B and SP-C by enzyme-linked immunosorbent assay.Results Compared with group C,the oxygenation index was significantly increased at T2,3,the intrapulmonary shunt rate was decreased,the concentrations of SP-B and SPC in serum were decreased,and the concentrations of SP-B and SP-C in broncho-alveolar lavage fluid were increased in group A (P＜0.05).Conclusion Giving apneic oxygen insufflation 5 L/min to the operated lung during OLV can reduce the damage to the operated lung.