Effects of sevoflurane combined with propofol on lung protection and serum ICAM-1, HMGB1 level in patients undergoing one lung ventilation

Abstract

Objective To investigate the protective effect and mechanism of sevoflurane combined with propofol on lung in patients with one lung ventilation and the effect of sevoflurane combined with propofol on serum intercellular adhesion molecule 1 (ICAM-1), high mobility group protein 1 (HMGB1) level. Methods 120 patients who were treated in Anhui Provincial Hospital from October 2014 to September 2018 were selected and divided into control group (n=60) and observation group (n=60). The control group was given sevoflurane maintenance anesthesia and the observation group was given sevoflurane propofol maintenance anesthesia.Before and after one lung ventilation, The hemodynamic indexes of two groups were observed and compared: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), mean arterial pressure (MAP), respiratory mechanics index: tidal volume (VT), mean airway pressure(Pmean), airway pressure(Ppeak), dynamic pulmonary compliance (Cdyn), propylene glycol (MDA), superoxide disproportionation alcohol (SOD). HMGB1, ICAM-1, xanthine oxidase and myeloperoxidase levels. Results There showed no significant difference in HR, SBP, DBP, MAP, VT, Pmean, Ppeak, Cdyn, MDA, SOD, HMGB1 and ICAM-1 levels between the two groups before one lung ventilation (P>0.05). With the increase of ventilation time, the HR, SBP, DBP, MAP of both groups decreased (P<0.05), but the observation group was lower than the control group (P<0.05). The levels of VT, Pmean, Ppeak, Cdyn, MDA, SOD, HMGB1 and ICAM-1 in the observation group were lower than those of the control group after one-lung ventilation(P<0.05). The levels of xanthine oxidase and myeloperoxidase in the observation group were lower than those in the control group (P<0.05). Conclusions Sevoflurane combined with propofol in the treatment of patients with one lung ventilation can protect the pulmonary function of patients, reduce the inflammatory response of patients, improve the oxidative stress response, and help the body to maintain stable hemodynamics. Key words: Pulmonary ventilation; Propofol; Cell adhesion molecules; High mobility group proteins