Abstract
Aim: To identify changes in the biochemical and biophysical behavior of lung surfactant (LS) in the unventilated and ventilated lung during surgery in patients with nonsmall cells lung cancer (NSCLC). The relationship between the surfactant changes and complications was examined.
Material and Methods: In prospective study we included 32 patients (SG) with NSCLC and a control group(CG) of 29 patients without cancer. Surgery was performed under general anesthesia and a double lumen tube intubation. In both groups we performed bronchoalveolar lavage (BAL): A. From the operated (nonventilated) lung after intubation and before reventilation; B. From ventilated lung after intubation and at the end of anestesia. Biochemical analysis: the amount of phospholipids, cholesterol and proteins. Biophysical analysis: the equilibrium surface tension(γeq) and dynamic characteristics of monolayers (minimal surface tension γmin, maximal surface tension, γmax).
Results: In SG the amount of LS phospholipids was significantly lower, as compared to the CG (70.4 vs. 219.2 µg/mg protein). In addition, we detected an increase in the amount of the LS proteins (mg/ml) in the second samples of both lungs: ventilated (0.13 vs. 0.42) and nonventilated(0.23 vs. 0.47). We noticed a deterioration of γeq in cancer patients as compared to the CG (43.11 vs. 29.4 mN/m). γmin was increased in the second samples: ventilatedlung (10.98 vs. 14.3 mN/m) and unventilatedlung (9.65 vs. 17.69 mN/m). Respiratory postoperative complications were observed - hypoventilation in 8 patients , pneumonia - in 3.
Conclusion: Lung cancer patients have changed behavior of LS. Hypoxia and inhalation anesthesia affects the biochemical and biophysical properties of LS.
- © 2014 ERS
