Effect of Protective Ventilation on Postoperative Lung Injury during one-lung Ventilation

【Objective】 To evaluate the efficacy of individual protective ventilation strategy on the postoperative lung injury during one-lung ventilation (OLV). 【Methods】 Thirty-two patients undergoing pulmonary resection were randomly divided into two groups. Traditional ventilation group (TG): tidal volume 8 mg/kg and peak inspiratory pressure (PIP)＜30 cmH2O. Protective ventilation group (PG): tidal volume l/2V (half-tidal-volume from preoperative pulmonary function test) and PIP＜25 cmH2O. The arterial blood samples were collected for blood gases analysis immediately 20 minutes after two-lung ventilation (TLV) in the supine position alter anesthesia (T1) and the end of operation (T2). The values of PaO2, PaCO2, pH and the inspired oxygen fraction (FiO2) were recorded and the values of oxygenation index (OI) were calculated respectively. The venous blood samples were collected for measurement of plasma interleukin-6 (IL-6) level at two time points. 【Results】 In all the patients, a decrease in OI and increase in plasma IL-6 level occurred at the end of operation (P＜0.05). There were no significant differences of changes between the TG and the PG (P＞0.05). For the overweight patients (difference between body weight and predicted body weight higher 10 kg), the decreases in OI were larger in traditional ventilation strategy than those in protective ventilation strategy (P＜0.05). 【Conclusion】 During OLV, the individual protective ventilation strategy moderates the postoperative lung injury for the overweight patients.