Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial
One-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to r...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2018/2575910 |
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| author | Chun-Yu Wu Yi-Fan Lu Man-Ling Wang Jin-Shing Chen Yen-Chun Hsu Fu-Sui Yang Ya-Jung Cheng |
| author_facet | Chun-Yu Wu Yi-Fan Lu Man-Ling Wang Jin-Shing Chen Yen-Chun Hsu Fu-Sui Yang Ya-Jung Cheng |
| author_sort | Chun-Yu Wu |
| collection | DOAJ |
| description | One-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to receive dexmedetomidine or saline during thoracoscopic surgery. There is a trend of less postoperative medical complication including that no patients in the dexmedetomidine group developed postoperative medical complications, whereas four patients in the saline group did (0% versus 13.3%, p=0.1124). Plasma inflammatory and injurious biomarkers between the baseline and after resumption of two-lung ventilation were particularly notable. The plasma high-mobility group box 1 level decreased significantly from 51.7 (58.1) to 33.9 (45.0) ng.ml−1 (p<0.05) in the dexmedetomidine group, which was not observed in the saline group. Plasma monocyte chemoattractant protein 1 [151.8 (115.1) to 235.2 (186.9) pg.ml−1, p<0.05] and neutrophil elastase [350.8 (154.5) to 421.9 (106.1) ng.ml−1, p<0.05] increased significantly only in the saline group. In addition, plasma interleukin-6 was higher in the saline group than in the dexmedetomidine group at postoperative day 1 [118.8 (68.8) versus 78.5 (58.8) pg.ml−1, p=0.0271]. We conclude that dexmedetomidine attenuates one-lung ventilation-associated inflammatory and injurious responses by inhibiting alveolar neutrophil recruitment in thoracoscopic surgery. |
| format | Article |
| id | doaj-art-0ae494405c3d4a0fbff5e7f537bcf57f |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-0ae494405c3d4a0fbff5e7f537bcf57f2025-02-03T06:08:37ZengWileyMediators of Inflammation0962-93511466-18612018-01-01201810.1155/2018/25759102575910Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled TrialChun-Yu Wu0Yi-Fan Lu1Man-Ling Wang2Jin-Shing Chen3Yen-Chun Hsu4Fu-Sui Yang5Ya-Jung Cheng6Anesthesiology Department, National Taiwan University Hospital, TaiwanAnesthesiology Department, National Taiwan University Hospital, Hsinchu Branch, TaiwanAnesthesiology Department, National Taiwan University Hospital, TaiwanSurgery Department, National Taiwan University Hospital, Taipei, TaiwanAnesthesiology Department, National Taiwan University Hospital, TaiwanAnesthesiology Department, National Taiwan University Hospital, TaiwanAnesthesiology Department, National Taiwan University Hospital, TaiwanOne-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to receive dexmedetomidine or saline during thoracoscopic surgery. There is a trend of less postoperative medical complication including that no patients in the dexmedetomidine group developed postoperative medical complications, whereas four patients in the saline group did (0% versus 13.3%, p=0.1124). Plasma inflammatory and injurious biomarkers between the baseline and after resumption of two-lung ventilation were particularly notable. The plasma high-mobility group box 1 level decreased significantly from 51.7 (58.1) to 33.9 (45.0) ng.ml−1 (p<0.05) in the dexmedetomidine group, which was not observed in the saline group. Plasma monocyte chemoattractant protein 1 [151.8 (115.1) to 235.2 (186.9) pg.ml−1, p<0.05] and neutrophil elastase [350.8 (154.5) to 421.9 (106.1) ng.ml−1, p<0.05] increased significantly only in the saline group. In addition, plasma interleukin-6 was higher in the saline group than in the dexmedetomidine group at postoperative day 1 [118.8 (68.8) versus 78.5 (58.8) pg.ml−1, p=0.0271]. We conclude that dexmedetomidine attenuates one-lung ventilation-associated inflammatory and injurious responses by inhibiting alveolar neutrophil recruitment in thoracoscopic surgery.http://dx.doi.org/10.1155/2018/2575910 |
| spellingShingle | Chun-Yu Wu Yi-Fan Lu Man-Ling Wang Jin-Shing Chen Yen-Chun Hsu Fu-Sui Yang Ya-Jung Cheng Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial Mediators of Inflammation |
| title | Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial |
| title_full | Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial |
| title_fullStr | Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial |
| title_full_unstemmed | Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial |
| title_short | Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial |
| title_sort | effects of dexmedetomidine infusion on inflammatory responses and injury of lung tidal volume changes during one lung ventilation in thoracoscopic surgery a randomized controlled trial |
| url | http://dx.doi.org/10.1155/2018/2575910 |
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