Effect of inhaled budesonide before operation on inflammatory responses to one-lung ventilation in patients undergoing thoracotomy

Abstract

Objective To evaluate the effect of inhaled budesonide before operation on the inflammatory responses to one-lung ventilation (OLV) in patients undergoing thoracotomy.Metheds Fifty ASA Ⅰ or Ⅱ physical status patients,aged 20-60 yr,weighing 50-80 kg,undergoing pulmonary lobectomy,were randomly divided into 2 groups (n =25 each):control group (group C) and budesonide group (group B).The patients inhaled normal saline and budesonide 1 mg for 20 min before operation in groups C and B,respectively.Before OLV (T1),at 30 min after OLV (T2),and at 24 and 48 h after operation (T3-4),arterial blood samples were collected for blood gas analysis and venous blood samples were collected for determination of serum concentrations of TNF-α,IL-1,IL-6,IL-8 and IL-10.Oxygenation index was calculated at T1-4.Airway peak pressure,airway plateau pressure and lung compliance were recorded at T1 and T2.Broncho-alveolar lavage fluid (BALF) of the ventilated lung was collected at T1 and T2 for determination of concentrations of TNF-α,IL-1,IL-6,IL-8 and IL-10.Results Compared with group C,airway peak pressure and airway plateau pressure were significandy decreased at T1 and T2,ling compliance was increased at T1 and T2,the concentrations of TNF-α,IL-1,IL-6 and IL-8 in BALF were decreased at T2,oxygenation index was increased and serum concentrations of TNF-α,IL-1,IL-6,IL-8 and IL-10 were decreased at T2-4 in group B (P ＜ 0.05).There was no significant difference in PaCO2 at each time point between the two groups (P ＞ 0.05).Conclusion Inhaled budesonide before operation can inhibit the inflammatory responses to OLV in patients undergoing thoracotomy,and is helpful in improving lung function. Key words: Budesonide ; Respiration, artificial ; Inflammation