Effects of prostaglandin E 1 nebulization of ventilated lung under 60%O 2 one lung ventilation on patients’ oxygenation and oxidative stress: a randomised controlled trial

摘要

BackgroundHigh FiOsub2/sub during one-lung ventilation (OLV) can improve oxygenation, but increase the risk of atelectasis and oxidative stress. The aim of this study was to analyze whether Prostaglandin Esub1/sub (PGEsub1/sub) can improve oxygenation and attenuate oxidative stress during OLV under a lower FiOsub2/sub.MethodNinety patients selectively undergoing thoracotomy for esophageal cancer were randomly divided into three groups ( n =?30/group): Group P (FiOsub2/sub?=?0.6, inhaling PGEsub1/sub 0.1?μg/kg), Group L (FiOsub2/sub?=?0.6) and Group C (FiOsub2/sub?=?1.0). The primary outcomes were oxygenation and pulmonary shunt during OLV. Secondary outcomes included haemodynamics, respiratory mechanics and oxidative stress in serum.ResultsPatients in Group P had significantly higher PaOsub2/sub and lower shunt fraction in 30?min of OLV compared with Group L. Compared with Group C, patients in Group P had similar levels of PaOsub2/sub/FiOsub2/sub in 60?min and higher levels of PaOsub2/sub/FiOsub2/sub at 2?h during OLV. The levels of PvOsub2/sub and SvOsub2/sub in Group P and Group L?were significantly lower than Group C. Patients in Group P and Group L had significantly higher levels of superoxide dismutase and lower levels of malondialdehyde than Group C. No significant differences were found in SPOsub2/sub, ETCOsub2/sub, PaCOsub2/sub, Paw, HR and MAP among the three groups. The complications in Group C were significantly higher than another two groups.ConclusionPGEsub1/sub can maintain adequate oxygenation in patients with low FiOsub2/sub (0.6) during OLV. Reducing FiOsub2/sub to 0.6 during OLV can decrease the levels of oxidative stress and complications after OLV.