RT Journal Article
SR Electronic
T1 Cytokine response in the lungs, pleural fluid and serum in children after thoracic surgery using one- lung ventilation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3496
VO 40
IS Suppl 56
A1 Dmytro Dmytriiev
A1 Oleksander Katilov
A1 Oleksander Mazulov
A1 Kateryna Dmytriieva
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3496.abstract
AB Thoracic surgery mandates usually a one-lung ventilation (OLV) strategy with the collapse of the operated lung and ventilation of the non-operated lung. These procedures trigger a substantial inflammatory response. The aim of this study was to analyze the cytokine reaction in both lungs, pleural space and blood in patients undergoing lung resection with OLV.METHODS: Broncho-alveolar lavage (BAL) fluid of both the collapsed, operated and the ventilated, non-operated lung, respectively, pleural space drainage fluid and blood was collected and the concentrations of interleukin (IL)-6, IL-1RA were determined with enzyme-linked immunosorbent assays in 24 patients.RESULTS: Substantial inter-individual differences in the BAL fluid between patients in cytokine levels occurred. In the pleural fluid and the blood these inter-individual differences were less pronounced. Both sides of the lung were affected and showed a significant increase in IL-6 (14.2 +/- 2.2 and 1.8 +/- 0.7 pg/mL (mean +/- se) and IL-1RA (23.2 +/- 1.7 and 4.2 +/- 2.6 pg/mL (mean +/- se) concentrations over time in the children with one-lung ventilation (OLV) and non one-lung ventilation (p < 0.001)). Except for IL-6, which increased more in the collapsed, operated lung, no difference between the collapsed, operated and the ventilated, non-operated lung occurred. In the blood, IL-6 and IL-1RA increased early, already at the end of surgery.CONCLUSION: The inflammatory response of cytokines affects both the collapsed, operated and the ventilated, non-operated lungs. The difference in extent of response underlines the complexity of the inflammatory processes during OLV In contrast to the cytokines.