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BMC Anesthesiol. 2016 Jul 30;16(1):47. doi: 10.1186/s12871-016-0209-y.

Low tidal volume ventilation with low PEEP during surgery may induce lung inflammation.

Author information

1
Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.
2
Present address: Department of Anesthesiology, Yokohama City University Medical Center, Kanagawa, Japan.
3
Present address: Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Kanagawa, Japan.
4
Present address: Operation Department, Yokohama City University Medical Center, Kanagawa, Japan.
5
Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan. kiyok@med.yokohama-cu.ac.jp.
6
Present address: Department of Anesthesiology, Yokohama City University Medical Center, Kanagawa, Japan. kiyok@med.yokohama-cu.ac.jp.
7
Present address: Division of Critical Care Medicine, Yokohama City University Medical Center, Kanagawa, Japan. kiyok@med.yokohama-cu.ac.jp.

Abstract

BACKGROUND:

Compared 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.

METHODS:

We randomly assigned patients undergoing hepatectomy into 2 groups: conventional tidal-volume vs. low tidal-volume (12 vs. 6 mL•kg(-1) 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.

RESULTS:

Twenty-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.

CONCLUSIONS:

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

TRIAL REGISTRATION:

The effect of ventilatory tidal volume on lung injury during hepatectomy that requires transient liver blood flow interruption. UMIN000021371 (03/07/2016); retrospectively registered.

KEYWORDS:

Cytokines; Hepatectomy; Micro-sampling Method; Systemic Inflammatory Response Syndrome; Ventilator-Induced Lung Injury

PMID:
27473050
PMCID:
PMC4967315
DOI:
10.1186/s12871-016-0209-y
[Indexed for MEDLINE]
Free PMC Article

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