Histochemical alterations in one lung ventilation.
BACKGROUND
One lung ventilation is a commonly performed surgical procedure. Although there have been several reports showing that one-lung ventilation can cause pathophysiological alterations such as pulmonary hypoxic vasoconstriction and intrapulmonary shunting, there have been virtually no reports on the effects of one-lung ventilation on lung histology.


METHODS
Yorkshire pigs (11-17 kg) were anesthetized, a tracheotomy performed and a tracheal tube inserted. The chest was opened and one lung ventilation (OLV), was induced by clamping of the right main bronchus. OLV was continued for 60 min before the clamp was removed and two lung ventilation (TLV) started. TLV was continued for 30 to 60 min. Blood and lung biopsies were taken immediately before OLV, 30 min and 60 min of OLV and after restoration of TLV.


RESULTS
Histological analyses revealed that the non-ventilated lung was totally collapsed during OLV. On reventilation, there was clear evidence of vascular congestion and alveolar wall thickening at 30 min after TLV. At 60 min of TLV, there was still vascular congestion. Serum nitrite levels (as an index of nitric oxide production) showed steady decline over the course of the experimental period, reaching a significantly low level on reventilation (compared with baseline levels before OLV). Lung MPO activity (marker of neutrophil sequestration) and serum TNFalpha levels were not raised during the entire experimental period.


CONCLUSIONS
These results suggest that there was lung vascular injury after OLV, which was associated with reduced levels of nitric oxide production and not associated with an inflammatory response.
Yin
Kingsley
K
Department of Cell Biology, University of Medicine and Dentistry, NJ-School of Osteopathic Medicine, Stratford, New Jersey 08084, USA. yinki@umdnj.edu
Gribbin
Elizabeth
E
Emanuel
Steven
S
Orndorff
Rebecca
R
Walker
Jean
J
Weese
James
J
Fallahnejad
Manucher
M
D000818:Animals; D008168:Lung / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D009504:Neutrophils / Q000201:enzymology; D009573:Nitrites / Q000097:blood; D010100:Oxygen / Q000097:blood; D009195:Peroxidase / Q000378:metabolism; D011183:Postoperative Complications / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D001261:Pulmonary Atelectasis / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D011652:Pulmonary Circulation; D012121:Respiration, Artificial / Q000379:methods*; D034421:Sus scrofa; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014661:Vasoconstriction
D009573:Nitrites; D014409:Tumor Necrosis Factor-alpha; D009195:Peroxidase; D010100:Oxygen