title: Impact of a lung-protective ventilatory strategy on systemic and pulmonary inflammatory responses during laparoscopic surgery: is it really helpful?
abstract: Laparoscopic surgery is performed by carbon dioxide (CO2) insufflation, but this may induce stress responses. The aim of this study is to compare the level of inflammatory mediators in patients receiving low tidal volume (VT) versus traditional VT during gynecological laparoscopic surgery. Forty American Society of Anesthesiologists (ASA) physical status 1 and 2 subjects older than 18 years old undergoing laparoscopic gynecological surgery were included. Systemic inflammatory response was assessed with serum IL-6, TNF-alpha, IL-8, and IL-1β in patients receiving intraoperative low VT and traditional VT during laparoscopic surgery [within the first 5 min after endotracheal intubation (T1), 60 min after the initiation of mechanical ventilation (T2), and in the postanesthesia care unit 30 min after tracheal extubation (T3)]. Additionally, inflammatory response was assessed with bronchoalveolar lavage (BAL) at T1 and T3 periods. An increase in the serum levels of IL-6, TNF-alpha, IL-8, and IL-1β was observed in both groups during the time periods of T1, T2, and T3. No significant differences were found in the serum and BAL levels of inflammatory mediators during time periods between groups. The results of the present study suggested that the lung-protective ventilation and traditional strategies are not different in terms of lung injury and inflammatory response during conventional laparoscopic gynecological surgery.
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Kokulu
authors.forename: Ersin
authors.initials: E
authors.lastname: Günay
authors.forename: Elif Doğan
authors.initials: ED
authors.lastname: Baki
authors.forename: Sevinc Sarinc
authors.initials: SS
authors.lastname: Ulasli
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmazer
authors.forename: Buğra
authors.initials: B
authors.lastname: Koca
authors.forename: Dagistan Tolga
authors.initials: DT
authors.lastname: Arıöz
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Ela
authors.forename: Remziye Gül
authors.initials: RG
authors.lastname: Sivaci
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007430:Intraoperative Care / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects*; D055370:Lung Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D013990:Tidal Volume / Q000502:physiology*
chemical_list: D018836:Inflammation Mediators