TY - JOUR
TI - The degree of oxidative stress is associated with major adverse effects
after lung resection: A prospective study
AU - Misthos, P
AU - Katsaragakis, S
AU - Theodorou, D
AU - Milingos, N and
AU - Skottis, I
JO - European Journal of Cardio-Thoracic Surgery Supplements
PY - 2006
VL - 29
TODO - 4
SP - 591-595
PB - OXFORD UNIV PRESS INC
SN - 1567-4258
TODO - 10.1016/j.ejcts.2005.12.027
TODO - oxidative stress; lung reexpansion; postresectional complications
TODO - Objective: This prospective randomized study was conducted in order to
define the contribution of the generated oxygen and nitrogen reactive
species on postlobectomy morbidity and mortality. Patients and methods:
Between 2001 and 2003, 132 patients with non-small cell lung cancer
(NSCLC) were prospectively studied. The patients were grouped according
to one-lung ventilation (OLV) use or not and to the duration of lung’s
atelectasis. Group A included 50 patients with confirmed non-small cell
lung cancer who were subjected to lobectomy without one-tung
ventilation. Group B included 30 patients subjected to 60 min OLV. Group
C included 30 patients subjected to 90 min OLV. Group D included 22
patients subjected to 120 min OLV. Preoperative, intraoperative and
postoperative strict blood sampling protocol was followed.
Malondiadehyde (MDA) plasma levels were measured. The groups were
statistically compared for the occurrence of postoperative
complications. OLV (groups B-D) along with other clinical parameters
were entered in multivariate analysis as risk factors for complication
development. Measurements and results: Comparison of group A with groups
B-D (OLV) documented significant increase (p < 0.001) of MDA levels
during lung reexpansion. The magnitude of oxidative stress was related
to OLV duration (group D > group C > group B, all p < 0.001). Univariate
analysis disclosed a higher incidence of acute respiratory failure,
cardiac arrhythmias and pulmonary hypertension in group D. Multivariate
analysis revealed OLV as an independent risk factor for postoperative
development of cardiac arrhythmias and pulmonary hypertension.
Conclusion: Protracted (> 1 h) OLV should be considered a potential
cause for cardiovascular complications through the generation of severe
oxidative stress due to lung reexpansion. (c) 2006 Published by Elsevier
B.V.
ER -