title: Glutathione oxidation correlates with one-lung ventilation time and PO2/FiO2 ratio during pulmonary lobectomy.
abstract: OBJECTIVE
  During lung lobectomy, the operated lung completely collapses with simultaneous hypoxic pulmonary vasoconstriction, followed by expansion and reperfusion. Here, we investigated glutathione oxidation and lipoperoxidation in patients undergoing lung lobectomy, during one-lung ventilation (OLV) and after resuming two-lung ventilation (TLV), and examined the relationship with OLV duration.
  
  
  METHODS
  We performed a single-centre, observational, prospective study in 32 patients undergoing lung lobectomy. Blood samples were collected at five time-points: T0, pre-operatively; T1, during OLV, 5 minutes before resuming TLV; and T2, T3, and T4, respectively, 5, 60, and 180 minutes after resuming TLV. Samples were tested for reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione redox potential, and malondialdehyde (MDA).
  
  
  RESULTS
  GSSG and MDA blood levels increased at T1, and increased further at T2. OLV duration directly correlated with marker levels at T1 and T2. Blood levels of GSH and glutathione redox potential decreased at T1-T3. GSSG, oxidized glutathione/total glutathione ratio, and MDA levels were inversely correlated with arterial blood PO2/FiO2 at T1 and T2.
  
  
  CONCLUSIONS
  During lung lobectomy and OLV, glutathione oxidation, and lipoperoxidation marker blood levels increase, with further increases after resuming TLV. Oxidative stress degree was directly correlated with OLV duration, and inversely correlated with arterial blood PO2/FiO2.
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: José
authors.initials: J
authors.lastname: García-de-la-Asunción
authors.affiliation: b Department of Thoracic Surgery , Consorcio Hospital General Universitario de Valencia , Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: García-Del-Olmo
authors.affiliation: c Department of Thoracic Surgery , Hospital Clínico Universitario de Valencia , Spain.
authors.forename: Genaro
authors.initials: G
authors.lastname: Galan
authors.affiliation: b Department of Thoracic Surgery , Consorcio Hospital General Universitario de Valencia , Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Guijarro
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martí
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Badenes
authors.affiliation: d Laboratory of Biochemistry , Hospital Clínico Universitario de Valencia , Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Perez-Griera
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Duca
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Delgado
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Carbonell
authors.affiliation: a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Belda
mesh_terms: D000368:Aged; D005260:Female; D005978:Glutathione / Q000378:metabolism; D019803:Glutathione Disulfide / Q000378:metabolism*; D006801:Humans; D008168:Lung / Q000378:metabolism* / Q000601:surgery*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000009:adverse effects*; D018384:Oxidative Stress / Q000502:physiology; D011446:Prospective Studies
chemical_list: D008315:Malondialdehyde; D005978:Glutathione; D019803:Glutathione Disulfide
keywords: Glutathione oxidation; Glutathione redox potential; Lung lobectomy; Malondialdehyde; One-lung ventilation; Oxidative lung injury