Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial.
Effects of Dexmedetomidine Infusion on Inflammatory Responses and Injury of Lung Tidal Volume Changes during One-Lung Ventilation in Thoracoscopic Surgery: A Randomized Controlled Trial.
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DOI：
10.1155/2018/2575910
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发表时间：
2018
影响因子：
4.6
通讯作者：
Cheng YJ
中科院分区：
文献类型：
--
作者：
Wu CY;Lu YF;Wang ML;Chen JS;Hsu YC;Yang FS;Cheng YJ
开胸手术中单肺通气可引起与肺潮气量改变相关的全身炎性反应和损伤。我们假设高选择性的α-肾上腺素能激动剂右旋美托咪定可以减弱这些损伤性反应。60例患者被随机分配到胸腔镜术中接受右美托咪定或生理盐水。术后医疗并发症有减少的趋势，右美托咪胺组无一例发生术后医疗并发症，而生理盐水组有4例发生术后医疗并发症(0%对13.3%，P=0.1124)。血浆炎症和损伤生物标志物在基线和恢复双肺通气后尤其显著。高迁移率组血浆−-1水平从51.7ng.ml(58.1)降至33.9ng.ml.ml.(p<；0.05)，而生理盐水组则未见明显变化。血浆单核细胞趋化蛋白1[151.8(115.1)~235.2(186.9)pg.ml−1，p<；0.05]和中性粒细胞弹性蛋白酶[350.8(154.5)~421.9(106.1)pg.ml−1，p<；0.05]仅在生理盐水组显著升高。此外，术后第1天生理盐水组血浆白介素6水平高于右美托咪丁组[118.8(68.8pg.ml−-1)比78.5pg(58.8pg)，P=0.0271]。我们得出结论，在胸镜手术中，右美托咪定通过抑制肺泡中性粒细胞的募集来减轻单肺通气相关的炎症和损伤反应。
One-lung ventilation in thoracic surgery provokes profound systemic inflammatory responses and injury related to lung tidal volume changes. We hypothesized that the highly selective a2-adrenergic agonist dexmedetomidine attenuates these injurious responses. Sixty patients were randomly assigned to receive dexmedetomidine or saline during thoracoscopic surgery. There is a trend of less postoperative medical complication including that no patients in the dexmedetomidine group developed postoperative medical complications, whereas four patients in the saline group did (0% versus 13.3%, p = 0.1124). Plasma inflammatory and injurious biomarkers between the baseline and after resumption of two-lung ventilation were particularly notable. The plasma high-mobility group box 1 level decreased significantly from 51.7 (58.1) to 33.9 (45.0) ng.ml−1 (p < 0.05) in the dexmedetomidine group, which was not observed in the saline group. Plasma monocyte chemoattractant protein 1 [151.8 (115.1) to 235.2 (186.9) pg.ml−1, p < 0.05] and neutrophil elastase [350.8 (154.5) to 421.9 (106.1) ng.ml−1, p < 0.05] increased significantly only in the saline group. In addition, plasma interleukin-6 was higher in the saline group than in the dexmedetomidine group at postoperative day 1 [118.8 (68.8) versus 78.5 (58.8) pg.ml−1, p = 0.0271]. We conclude that dexmedetomidine attenuates one-lung ventilation-associated inflammatory and injurious responses by inhibiting alveolar neutrophil recruitment in thoracoscopic surgery.
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影响因子：
--
作者：
Engels GE;van Oeveren W
通讯作者：
van Oeveren W
单肺通气期间的高氧：炎症和氧化反应。
影响因子：
3.1
作者：
Fisher, Alicia Olivant;Husain, Kamran;Wolfson, Marla R.;Hubert, Terrence L.;Rodriguez, Elena;Shaffer, Thomas H.;Theroux, Mary C.
通讯作者：
Theroux, Mary C.
DOI：
10.1152/ajplung.00359.2004
发表时间：
2005-05-01
影响因子：
4.9
作者：
Kim, JY;Park, JS;Abraham, E
通讯作者：
Abraham, E
DOI：
10.1165/ajrcmb/7.2.134
发表时间：
1992-08-01
影响因子：
6.4
作者：
BRIELAND, JK;JONES, ML;FANTONE, JC
通讯作者：
FANTONE, JC
影响因子：
3.4
作者：
Jiang L;Li L;Shen J;Qi Z;Guo L
通讯作者：
Guo L