Abstract
BackgroundHypoxic preconditioning (HPC) may protect multiple organs from various injuries. We hypothesized that HPC would reduce lung injury in patients undergoing thoracoscopic lobectomy.MethodsIn a prospective randomized controlled trial, 70 patients undergoing elective thoracoscopic lobectomy were randomly allocated to the HPC group or the control group. Three cycles of 5-min hypoxia and 3-min ventilation applied to the nondependent lung served as the HPC intervention. The primary outcome was the PaO2/FiO2 ratio. Secondary outcomes included postoperative pulmonary complications, pulmonary function, and duration of hospital stay.ResultsHPC significantly increased the PaO2/FiO2 ratio compared with the control at 30 min after one-lung ventilation and 7 days after operation. Compared with the control, it also significantly improved postoperative pulmonary function and markedly reduced the postoperative hospital stay duration. No significant differences between groups were observed in the incidence of pulmonary complications or overall postoperative morbidity.ConclusionsHPC improves postoperative oxygenation, enhances the recovery of pulmonary function, and reduces the duration of hospital stay in patients undergoing thoracoscopic lobectomy.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17011249) on April 27, 2017.
Highlights
Hypoxic preconditioning (HPC) may protect multiple organs from various injuries
A total of 78 patients were screened for eligibility, and eight patients were excluded from analysis
No differences were observed between two groups regarding age, sex, weight, height, comorbidities, and preoperative pulmonary function
Summary
Hypoxic preconditioning (HPC) may protect multiple organs from various injuries. One-lung ventilation (OLV) techniques are required to facilitate the surgical procedure in patients undergoing lung cancer surgery. This technique is associated with hypoxia and Hypoxic preconditioning (HPC) or ischemic preconditioning (IPC) can improve the tolerance of cells, tissues, entire organs, and even the organism itself to subsequent severe hypoxia or ischemia [6,7,8]. A recent clinical trial found that a 10-min HPC could protect the kidneys from ischemic injury and postsurgical dysfunction in patients undergoing coronary artery bypass surgery [14]
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