title: Does on-pump normothermic beating-heart valve surgery with low tidal volume ventilation protect the lungs?
abstract: BACKGROUND
  Postoperative pulmonary dysfunction following cardiopulmonary bypass (CPB) usually develops secondary to the inflammatory process with contact activation, hypothermia, operative trauma, general anesthesia, atelectasis, pain, and pulmonary ischemia/reperfusion due to cross-clamping. The aim of the present study was to evaluate the effects of an on-pump, normothermic, and beating-heart technique and of low-volume ventilation on lung injury.
  
  
  METHODS
  We compared the results for 20 patients who underwent operations with an on-pump, normothermic, and beating-heart technique of mitral valve surgery with low-volume ventilation (group 1) with the results for 23 patients who underwent their operations with an on-pump, hypothermic cardiac-arrest technique (group 2). In both groups, blood samples were collected from the right superior pulmonary vein, and inflammation and oxidative stress markers (malondialdehyde, lactic acid, platelet-activating factor, and myeloperoxidase) were studied.
  
  
  RESULTS
  Malondialdehyde, myeloperoxidase, and lactate values were significantly lower in group 1 than in group 2 just before the termination of CPB (P < .05). We observed no differences between the 2 groups with regard to values for platelet-activating factor.
  
  
  CONCLUSIONS
  Inflammation and oxidative stress markers were lower in the group of patients who underwent beating-heart valve surgery with low-volume ventilation. These results reflect less of an ischemic insult and lower inflammation compared with the results for the patients who underwent conventional operations.
authors: Department of Cardiovascular Surgery, Türkiye Yüksek htisas E itim ve Ara tırma, Hastanesi, Ankara. ufuktutun@hotmail.com
authors: Ufuk
authors: U
authors: Tütün
authors: Ali Ihsan
authors: AI
authors: Parlar
authors: Levent
authors: L
authors: Altinay
authors: Deniz Ilhan
authors: DI
authors: Topcu
authors: Seyhan
authors: S
authors: Babaroglu
authors: Kerem
authors: K
authors: Yay
authors: Ufuk
authors: U
authors: Mungan
authors: Ferit
authors: F
authors: Cicekcioglu
authors: Gul Sevim
authors: GS
authors: Saydam
authors: Salih Fehmi
authors: SF
authors: Katircioglu
mesh_terms: D015415:Biomarkers; D006348:Cardiac Surgical Procedures / Q000295:instrumentation; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007249:Inflammation / Q000209:etiology; D019344:Lactic Acid / Q000097:blood; D008168:Lung; D055370:Lung Injury / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D018384:Oxidative Stress; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D015415:Biomarkers; D019344:Lactic Acid