Effect of remote ischemic preconditioning combined with dexmedetomidine on lung injury during one-lung ventilation in patients undergoing thoracic surgery
10.3760/cma.j.issn.0254-1416.2014.11.002
- VernacularTitle:远隔缺血预处理联合右美托咪定对开胸手术患者单肺通气时肺损伤的影响
- Author:
Jian LU
;
Wangpin XIAO
;
Hongmei ZHOU
;
Qinghe ZHOU
;
Yejun ZHAO
;
Yingyan SHEN
- Publication Type:Journal Article
- Keywords:
Extremities;
Ischemic preconditioning;
Dexmedetomidine;
Respiration,artificial;
Respiratory distress syndrome,adult
- From:
Chinese Journal of Anesthesiology
2014;34(11):1297-1299
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investiga~ the effect of remote ischemic preconditioning (RIPC) combined with dexmedetomidine on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery.Methods Thirty ASA physical status Ⅰ or Ⅱ patients,aged 45-70 yr,weighing 51-69 kg,scheduled for elective radical operation for esophageal cancer,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and RIPC combined with dexmedetomidine group (group ORD).In ORD group,at 10 min after endotracheal intubation,RIPC was induced by 3 cycles of 5 min lower extremity ischemia followed by 5 min reperfusion,and at the same time a loading dose of dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min and then dexmedetomidine was infused at a rate of 0.5 μg· kg-1 · h-1 until the end of operation.At 0,30 min,1 h and 2 h of OLV (T1-4),blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β) and IL-10.Oxygenation index and respiratory index were calculated.Exhaled breath condensate was collected at T1,T3 and T4,and the pH value was measured.Results Compared with group C,oxygenation index was significantly increased,and respiratory index was decreased at T2-4,the plasma concentrations of TNF-α and IL-1β were decreased,and the pH value of exhaled breath condensate was increased at T3-4,and the plasma concentration of IL-10 was increased at T4 in group ORD.Conclusion RIPC combined with dexmedetomidine can inhibit inflammatory responses and reduce airway acidification,thus attenuating the lung injury during OLV in the patients undergoing thoracic surgery.
