ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
One-lung ventilation duration-dependent stress response in thoracotomies and the effect of a low-volume, high-frequency differentiated ventilation strategy on this response
Şükran Geze1, Celal Tekinbaş2, Hülya Ulusoy1, Ahmet Menteşe4, Murat Topbaş5, Mesut Karaca3
1Department of Anesthesiology and Critical Care, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey
2Department of Thoracic Surgery, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey
3Department of Anesthesiology and Reanimation, Simav Hospital, Kütahya, Turkey
4Program of Medical Laboratory Techniques, Karadeniz Technical University, Health Services Vocational School, Trabzon, Turkey
5Department of Public Health, Karadeniz Technical University Faculty of Medicine Farabi Hospital, Trabzon, Turkey
DOI : 10.5606/tgkdc.dergisi.2019.16826
Background: This study aims to investigate the effect of ventilation of the non-ventilated lung in patients undergoing one-lung ventilation by a separate low-tidal-volume (1 mL/kg) ventilator at high frequency (30/min) on preventing the effect of one-lung ventilation-associated oxidative damage.

Methods: The study included 45 patients (24 males, 21 females; mean age 54.6±7.7 years; range, 18 to 65 years) with an American Society of Anesthesiologists risk group of 1 to 2 and scheduled for elective thoracotomy. Patients were randomly divided into three groups as those due for thoracotomy without one-lung ventilation (group 1, n=15), those due for thoracotomy with one-lung ventilation (group 2, n=15), and those due for thoracotomy in whom both lungs were ventilated (group 3, n=15). Blood specimens were collected for ischemia-modified albumin, malondialdehyde, and lactate measurements one minute before one-lung ventilation (t0), 30 minutes after one-lung ventilation (t1), 60 minutes after one-lung ventilation (t2), and at postoperative 24th hour (t3). For group 1, t0 was defined as the time at which the thorax was opened.

Results: A statistically significant increase in ischemia-modified albumin, malondialdehyde, and lactate levels occurred in group 2 as the duration of one-lung ventilation increased (p<0.01). Plasma ischemia-modified albumin and malondialdehyde levels in group 3 were statistically significantly lower at t1, t2, and t3 compared with group 2 (p<0.01). Plasma lactate levels were significantly lower in group 3 at t1 (p<0.05) and t3 compared with group 2 (p<0.01).

Conclusion: Separate ventilation of the non-ventilated lung with low tidal volume and high frequency reduces the response to one-lung ventilation-associated oxidative stress in thoracic surgery.

Keywords : Differentiated ventilation strategy, one-lung ventilation, oxidative damage
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