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Perioperative changes in exhaled nitric oxide during oesophagectomy
Piers R Boshier1, Alison L Knaggs2, George B Hanna1
1Department of Surgery and Cancer, Imperial College London, United Kingdom.
Journal of Breath Research
|October 17, 2017
Summary
Exhaled nitric oxide (NO) levels change during oesophagectomy and one-lung ventilation (OLV), potentially indicating lung injury. These NO variations correlate with physiological markers and may predict postoperative respiratory complications.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pulmonary Physiology
Background:
- Oesophagectomy is a major surgery with high cardiopulmonary morbidity.
- Intraoperative one-lung ventilation (OLV) is frequently required, contributing to complications.
- Understanding physiological changes during OLV is crucial for patient outcomes.
Purpose of the Study:
- To investigate variations in exhaled nitric oxide (NO) during oesophagectomy.
- To assess the impact of OLV on exhaled NO levels.
- To correlate NO levels with physiological variables and clinical outcomes.
Main Methods:
- Breath-to-breath NO concentrations were measured in patients undergoing oesophagectomy.
- NO levels were analyzed during two-lung ventilation and OLV (selectively ventilated and collapsed lungs).
- Correlation with physiological variables (blood pressure, lactate) and postoperative complications was assessed.
Main Results:
- Exhaled NO levels showed dynamic changes throughout oesophagectomy and OLV.
- A significant reduction in NO was observed in the ventilated lung during OLV.
- NO levels correlated with systolic blood pressure and lactate, and tended to be higher in patients with respiratory complications.
Conclusions:
- Oesophagectomy and OLV significantly affect exhaled NO concentrations.
- Variations in NO may reflect altered NO balance and tissue injury during OLV.
- Further research is warranted to establish exhaled NO as a biomarker for lung injury in this context.