Lung protection of remote limb ischemic preconditioning during one-lung ventilation in patients undergoing esophageal cancer resection

Abstract

Objective To evaluate the lung protection of remote limb ischemic preconditioning during one-lung ventilation (OLV) in the patients undergoing esophageal cancer resection. Methods Seventy-one patients of both sexes, aged 30-64 yr, with body mass index of 15-28 kg/m2, of American Society of Anesthesiologists physical statusⅠor Ⅱ, scheduled for elective esophageal cancer resection, were randomly divided into control group (group C, n=34) and remote limb ischemic preconditioning group (group RLIP, n=37) using a random number table.Patients in group RLIP received three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on one upper arm before OLV.Before OLV (T0), at 1 and 2 h of OLV (T1, 2), at 20 min after re-expansion of the collapsed lung (T3), and at 2 h after operation (T4), blood samples were drawn from the radial artery for blood gas analysis, oxygenation index (PaO2/FiO2)and alveolar-arterial oxygen gradient (A-aDO2) were calculated.At T0, T2, T3 and T4, blood samples were collected from the radial artery for determination of plasma tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and IL-10 concentrations. Results Compared with group C, PaO2/FiO2 was significantly increased, and A-aDO2 was decreased at T1, 2, the plasma TNF-α concentrations were decreased at T2-4 (P 0.05). Conclusion Although remote limb ischemic preconditioning can produce lung protection during OLV in the patients undergoing esophageal cancer resection, it provides no clinical significance. Key words: Ischemic preconditioning; Extremities; Respiration, artificial; Respiratory distress syndrome, adult