Lung protection of remote limb ischemic preconditioning after pulmonary resection

Maimaiti Tuerxunayi, Aimaiti Abulikemu, M. Ning, Jia-rong Xu, Jiazheng Xu, Hai-ping Ma
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Abstract

Objective To evaluate lung protection of remote limb ischemic preconditioning after pulmonary resection. Methods Methods sixty adult patients scheduled for elective pulmonary resection, were randomly divided into control group(group C, 30 cases) and remote limb ischemic preconditioning(group RLIP, 30 cases) using a random number table. Before one-lung-ventilation(T0), at 30 minites, 1 hour and 2 hours of OLV(T1, 2, 3), 15minites after re-expansion of the collapsed lung(T4), blood samples were drawn from the radial artery and vein for blood gas analysis, alveolar-arterial oxygen gradient(A-aDO2)、pulmonary shunt ratio(Qs/Qt)were calculated. Extraction time of closed thoracic drainage tube, length of hospital stay, the incidence of in-hospital complications after operation were recorded. Results Compared to T0 , each group at T1-T4, A-aDO2 were obviously increased. We found that at T3, A-aDO2 of group C increased much more higher and statistically significant(P 0.05). Conclusion Remote limb ischemic preconditioning had some protective effect after pulmonary resection, which mechanism may be related to enhancing autophagy in the operated 1ung tissues of the patients. Key words: Ischemic preconditioning; One-lung ventilation; Autophagy; Lung protection; Pulmonary shunt
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肺切除术后远端肢体缺血预处理的肺保护作用
目的探讨肺切除术后远端肢体缺血预处理对肺的保护作用。方法采用随机数字表法将60例成人择期肺切除术患者随机分为对照组(C组,30例)和远端肢体缺血预处理组(RLIP组,30例)。单肺通气前(T0)、OLV 30min、1h、2h (T1、2、3)、萎陷肺再扩张后15min (T4)分别取桡动脉、静脉采血进行血气分析,计算肺泡-动脉氧梯度(A-aDO2)、肺分流比(Qs/Qt)。记录两组患者闭式胸腔引流管拔管时间、住院时间、术后院内并发症发生率。结果与T0比较,T1-T4各组A-aDO2均明显升高。T3时,C组A-aDO2升高幅度更大,差异有统计学意义(P < 0.05)。结论远端肢体缺血预处理在肺切除术后具有一定的保护作用,其机制可能与增强患者手术后肺组织的自噬有关。关键词:缺血预处理;侧通风;自噬;肺保护;肺分流
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