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Related Experiment Videos

Oxidative stress during 1-lung ventilation.

Ya-Jung Cheng1, Kuang-Cheng Chan, Chiang-Ting Chien

  • 1Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.

The Journal of Thoracic and Cardiovascular Surgery
|August 29, 2006
PubMed
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Resuming 2-lung ventilation after 1-lung ventilation significantly increases superoxide production. However, the body

Area of Science:

  • Anesthesiology and Critical Care Medicine
  • Pulmonary Physiology
  • Oxidative Stress Research

Background:

  • One-lung ventilation (OLV) followed by resumption of two-lung ventilation (TLV) may trigger re-expansion and reoxygenation.
  • Oxidative stress during the transition from OLV to TLV is not well understood, despite reported complications like re-expansion pulmonary edema.
  • This study investigates oxidative stress markers and hemodynamic changes during OLV/TLV.

Purpose of the Study:

  • To assess reactive oxygen species (ROS) production during the OLV/TLV transition.
  • To evaluate changes in total antioxidant status (TAS).
  • To monitor extravascular lung water (EVLW), cardiac output (CO), and intrathoracic blood volume (ITBV) using the Pulsion PiCCO system.

Main Methods:

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  • Twenty patients undergoing OLV (>60 minutes) for video-assisted thoracoscopic surgery were studied.
  • ROS production was measured using lucigenin and luminol chemiluminescence.
  • Measurements of ROS, TAS, EVLW, CO, and ITBV were taken at four time points: before OLV, before TLV, and 5 and 30 minutes after TLV.

    • Main Results:

    • Lucigenin chemiluminescence, indicating superoxide production, significantly increased post-TLV.
    • Total antioxidant status showed a nonsignificant decrease.
    • EVLW, ITBV, and permeability index remained largely unchanged, while CO significantly increased post-TLV.

    Conclusions:

    • Resuming TLV after OLV generates substantial superoxide production.
    • Adequate antioxidant capacity appears to counteract this, as evidenced by stable EVLW and ITBV.
    • Patients with compromised antioxidant capacity (e.g., cancer, trauma) may be at higher risk for oxidative injury.