One-lung ventilation: for how long?
OBJECTIVE
Lung injury induced by one-lung ventilation is rare, but it is a condition that may result in high mortality. This study evaluates the effects of one-lung ventilation and occlusion time on collapsed and contralateral lungs.


METHODS
Sprague-Dawley rats were allocated randomly into 7 groups consisting of 6 animals each: sham; O1, 1 hour of occlusion/2 hours of re-expansion; C1, 3 hours of mechanical ventilation control; O2, 2 hours of occlusion/2 hours of re-expansion; C2, 4 hours of mechanical ventilation control; O3, 3 hours of occlusion/2 hours of re-expansion; and C3, 5 hours of mechanical ventilation control groups. In the occlusion groups, the left lung was collapsed by bronchial occlusion. Malondialdehyde activity was determined in the blood, and myeloperoxidase and malondialdehyde activity was determined in the collapsed and contralateral lungs. Lung tissues were also examined histopathologically.


RESULTS
Malondialdehyde and myeloperoxidase levels rose as occlusion duration increased. This increase was greater in the occlusion groups than that in their own control groups. Increases were significant in the O2 compared with the O1 groups (P < .005). Histologically, tissue damage increased as occlusion time rose injury in collapsed and contralateral lungs. Injury was greater in the occlusion groups than injury in their own control groups (P < .005).


CONCLUSIONS
Our findings show that biochemical and histopathologic injury occur in collapsed and contralateral lungs in one-lung ventilation, and this injury increases as occlusion time rises. We believe that occlusion and occlusion time-related injury should be borne in mind in the clinic under conditions requiring the application of one-lung ventilation.
Department of Thoracic Surgery, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey. celaltekinbas3@hotmail.com
Celal
C
Tekinbas
Hulya
H
Ulusoy
Esin
E
Yulug
Mehmet Muharrem
MM
Erol
Ahmet
A
Alver
Engin
E
Yenilmez
Sukran
S
Geze
Murat
M
Topbas
D000818:Animals; D015227:Lipid Peroxidation; D008168:Lung / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D018709:Statistics, Nonparametric
D008315:Malondialdehyde; D009195:Peroxidase