Two-Lung Ventilation Attenuates Systemic Inflammatory and Oxidative Stress Responses During Thoracic Surgery: A...

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Thoracic surgery often involves one-lung ventilation (OLV), which can trigger inflammatory and oxidative responses.
• Understanding the impact of different ventilation strategies on perioperative outcomes is crucial.

Purpose of the Study:

• To compare the effects of two-lung ventilation (TLV) versus OLV on perioperative inflammatory and oxidative responses in patients undergoing thoracic surgery.

Main Methods:

• A randomized clinical trial involving 40 adult patients undergoing thoracic surgery.
• Patients were assigned to either OLV or TLV during the procedure.
• Bronchoalveolar lavage and plasma samples were collected to measure cytokines and oxidative stress markers.

Main Results:

• TLV did not significantly alter local interleukin-6 (IL-6) levels in bronchoalveolar lavage fluid.
• However, TLV was associated with reduced postoperative IL-1β and oxidative damage in the operated lung.
• Systemically, TLV significantly attenuated inflammatory and oxidative responses.

Conclusions:

• Two-lung ventilation (TLV) effectively dampens systemic inflammatory and oxidative activation following thoracic surgery.
• TLV may serve as a protective perioperative ventilatory strategy, despite not altering local IL-6 concentrations.