title: Low tidal volume ventilation with low PEEP during surgery may induce lung inflammation.
abstract: Compared to conventional tidal volume ventilation, low tidal-volume ventilation reduces mortality in cased of acute respiratory distress syndrome. The aim of the present study is to determine whether low tidal-volume ventilation reduces the production of inflammatory mediators in the lungs and improves physiological status during hepatic surgery.
  
  
  
  We randomly assigned patients undergoing hepatectomy into 2 groups: conventional tidal-volume vs. low tidal-volume (12 vs. 6 mL•kg(-1) ideal body weight) ventilation with a positive end-expiratory pressure of 3 cm H2O. Arterial blood and airway epithelial lining fluid were sampled immediately after intubation and every 3 h thereafter.
  
  
  
  Twenty-five patients were analyzed. No significant changes were found in hemodynamics or acid-base status during the study. Interleukin-8 was significantly elevated in epithelial lining fluid from the low tidal-volume group. Oxygenation evaluated immediately after admission to the post-surgical care unit was significantly worse in the low tidal-volume group.
  
  
  
  Low tidal-volume ventilation with low positive end-expiratory pressure may lead to pulmonary inflammation during major surgery such as hepatectomy.
  
  
  
  The effect of ventilatory tidal volume on lung injury during hepatectomy that requires transient liver blood flow interruption. UMIN000021371 (03/07/2016); retrospectively registered.
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.|Present address: Department of Anesthesiology, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sato
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.|Present address: Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Kyota
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.|Present address: Operation Department, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.|Present address: Department of Anesthesiology, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Terada
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Goto
authors.affiliation: Departments of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama, Japan. kiyok@med.yokohama-cu.ac.jp.|Present address: Department of Anesthesiology, Yokohama City University Medical Center, Kanagawa, Japan. kiyok@med.yokohama-cu.ac.jp.|Present address: Division of Critical Care Medicine, Yokohama City University Medical Center, Kanagawa, Japan. kiyok@med.yokohama-cu.ac.jp.
authors.forename: Kiyoyasu
authors.initials: K
authors.lastname: Kurahashi
mesh_terms: D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016209:Interleukin-8 / Q000097:blood; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011014:Pneumonia / Q000097:blood*; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood; D012121:Respiration, Artificial / Q000009:adverse effects*; D013990:Tidal Volume / Q000502:physiology*; D055815:Young Adult
chemical_list: D016209:Interleukin-8; D010100:Oxygen
keywords: Cytokines; Hepatectomy; Micro-sampling Method; Systemic Inflammatory Response Syndrome; Ventilator-Induced Lung Injury