TY - JOUR
TI - Postresectional pulmonary oxidative stress in lung cancer patients. The
role of one-lung ventilation
AU - Misthos, P
AU - Katsaragakis, S
AU - Milingos, N
AU - Kakaris, S and
AU - Sepsas, E
AU - Athanassiadi, K
AU - Theodorou, D
AU - Skottis, I
JO - European Journal of Cardio-Thoracic Surgery Supplements
PY - 2005
VL - 27
TODO - 3
SP - 379-382
PB - OXFORD UNIV PRESS INC
SN - 1567-4258
TODO - 10.1016/j.ejcts.2004.12.023
TODO - oxidative stress; lung reexpansion; lung reperfusion
TODO - Objective: The authors conducted a prospective analysis in order to
investigate through lipid peroxidation metabolites the generation of
oxygen free radicals after one-lung ventilation (OLV). Methods: From
2001 to 2003, 212 patients were prospectively studied for lung
reexpansion/reperfusion injury. They were classified in six groups.
Group A, non-OLV lobectomy group; B, OLV pneumonectonny group; C-E, OLV
lobectomy of 60, 90, and 120 min duration, respectively; F, normal
subjects as baseline group. Preoperative, intraoperative and
postoperative strict blood sampling protocol was followed.
Malondialdehyde (MDA) plasma levels were measured. The recorded values
were analyzed and statistically compared between groups and within each
one. Results: Comparison of groups C-E (OLV) to A other documented
significant (P < 0.001) increase of MDA levels during lung reexpansion
and for the following 12 h. The magnitude of oxidative stress was
related to OLV duration (group E > D > C, all P < 0.001). The removal of
cancer-associated parenchyma led to MDA level decrease postoperatively
(P < 0.001) especially after pneumonectomy (A vs. B, P < 0.001).
Conclusions: (1) Lung reexpansion provoked severe oxidative stress. (2)
The degree of the amount of generated oxygen free radicals was
associated to the duration of OLV. (3) Patients with lung cancer had a
higher production of oxygen free radicals than normal population.
(4)Tumor resection removes a large oxidative burden from the organism.
(5) Mechanical ventilation and surgical trauma are weak free radical
generators. (6) Manipulated lung tissue is also a source of oxygen free
radicals, not only intraoperatively but also for several hours later.
(c) 2005 Elsevier B.V. All rights reserved.
ER -