Low tidal volume ventilation with low PEEP during surgery may induce lung inflammationReport as inadecuate




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BMC Anesthesiology

, 16:47

Airway and respiratory management

Abstract

BackgroundCompared to conventional tidal volume ventilation, low tidal-volume ventilation reduces mortality in cased of acute respiratory distress syndrome. The aim of the present study is to determine whether low tidal-volume ventilation reduces the production of inflammatory mediators in the lungs and improves physiological status during hepatic surgery.

MethodsWe randomly assigned patients undergoing hepatectomy into 2 groups: conventional tidal-volume vs. low tidal-volume 12 vs. 6 mL•kg ideal body weight ventilation with a positive end-expiratory pressure of 3 cm H2O. Arterial blood and airway epithelial lining fluid were sampled immediately after intubation and every 3 h thereafter.

ResultsTwenty-five patients were analyzed. No significant changes were found in hemodynamics or acid–base status during the study. Interleukin-8 was significantly elevated in epithelial lining fluid from the low tidal-volume group. Oxygenation evaluated immediately after admission to the post-surgical care unit was significantly worse in the low tidal-volume group.

ConclusionsLow tidal-volume ventilation with low positive end-expiratory pressure may lead to pulmonary inflammation during major surgery such as hepatectomy.

Trial registrationThe effect of ventilatory tidal volume on lung injury during hepatectomy that requires transient liver blood flow interruption. UMIN000021371 03-07-2016; retrospectively registered

KeywordsCytokines Hepatectomy Systemic Inflammatory Response Syndrome Ventilator-Induced Lung Injury Micro-sampling Method  Download fulltext PDF



Author: Hitoshi Sato - Kyota Nakamura - Yasuko Baba - Shoko Terada - Takahisa Goto - Kiyoyasu Kurahashi

Source: https://link.springer.com/



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