[Changes in acid-base equilibrium, ventilation parameters and immunologic reactions in thoracoscopic operations].

Area of Science:

• Thoracic Surgery
• Anesthesiology
• Immunology

Context:

• Thoracoscopic surgery often requires isolating one lung using one-lung ventilation (OLV).
• Understanding the physiological and immunological consequences of OLV is crucial for patient safety.
• Previous research has not fully elucidated the impact of OLV on blood gases and immune mediators in thoracoscopic procedures.

Purpose:

• To investigate the changes in arterial blood gases and immune response mediators during thoracoscopic surgery with OLV.
• To assess the impact of OLV on cytokines and reactive oxygen species (ROS) in patients undergoing video-assisted thoracic surgery (VATS).

Summary:

• Thirty-eight patients undergoing thoracoscopic/VATS procedures were studied.
• Arterial blood gases, respiratory parameters, and vital signs were monitored before, during, and after OLV.
• Circulatory cytokines (IL-1β, IL-2, IL-6, IL-8, TNF-α) and ROS were measured at multiple time points, including pre- and post-operation.
• OLV led to a significant increase in PaCO2 and decrease in pH, with 34% developing respiratory acidosis.
• No significant changes in cytokine levels were observed, except for a mild increase in IL-6, IL-8, and TNF-α in the first 24 hours post-operation.
• ROS activity peaked at the end of surgery but did not significantly differ from baseline, decreasing within 24 hours.

Impact:

• Thoracoscopic/VATS procedures with OLV represent a minimal physiological load on patients.
• Observed changes in blood gases and pH during OLV did not appear to negatively impact patient outcomes.
• Proinflammatory cytokine levels and ROS activity remained largely unchanged, suggesting a limited inflammatory response to the procedure.