Synthesis of prostaglandins, TXA2 and PGI2, during one lung anesthesia.
This study is to determine histamine, serotonin, TXA2 and PGI2 to be the cause of Hypoxic Pulmonary Vasoconstriction (HPV) at the same time of one lung ventilation and thoracotomy. Five patients who were to undergo upper-lobe resection of the right lung, were included in this study. All patients underwent same premedication and anesthetic method. Endotracheal intubation was done with a Univent tracheal tube. Gas analysis and determinations of the substances were done at six times in total. Respiratory Index (RI) began to increase immediately after the start of one lung ventilation. Post-thoracotomy RI further increased. After closing of the thorax, RI returned to the control values. Serotonin and histamine showed no change in any case throughout the experiment. TXB2 began to increase along with the start of one lung ventilation. The 15-min value was 167.2 +/- 85.8 pg/ml and 30-min value was 345.6 +/- 261.2 pg/ml, showing significant increase. The values of 6-keto PGF1 alpha were 22.6 +/- 2.9 pg/ml (15-min value), 89.6 +/- 52.3 pg/ml (30-min value), 290.8 +/- 120.1 pg/ml (post opening value) and 84.4 +/- 21.3 pg/ml (post-closing value). In our study, we concluded that neither serotonin nor histamine was the direct factor of HPV. TXA2 was the direct chemical mediator of HPV and PGI2 showed a negative feedback to the pulmonary vasoconstriction.
Arima
T
T
Department of Anesthesiology, Saitama Medical School, Japan.
Matsuura
M
M
Shiramatsu
T
T
Gennda
T
T
Matsumoto
I
I
Hori
T
T
D015121:6-Ketoprostaglandin F1 alpha / Q000378:metabolism; D000777:Anesthetics / Q000494:pharmacology*; D011464:Epoprostenol / Q000502:physiology*; D006632:Histamine / Q000502:physiology*; D006801:Humans; D000860:Hypoxia; D008168:Lung / Q000601:surgery; D011652:Pulmonary Circulation / Q000187:drug effects*; D012119:Respiration; D012701:Serotonin / Q000502:physiology*; D013903:Thoracic Surgery; D013928:Thromboxane A2 / Q000502:physiology*; D013929:Thromboxane B2 / Q000378:metabolism; D013997:Time Factors; D014661:Vasoconstriction
D000777:Anesthetics; D012701:Serotonin; D013929:Thromboxane B2; D013928:Thromboxane A2; D015121:6-Ketoprostaglandin F1 alpha; D006632:Histamine; D011464:Epoprostenol