Dexmedetomidine Improves Lung Function by Promoting Inflammation Resolution in Patients Undergoing Totally Thoracoscopic Cardiac Surgery
| Autor: | Mintai Gao, Xiaoyan Huang, Junji Cui, Hongqian Huang, Qingshi Zeng |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Aging medicine.medical_specialty Time Factors Article Subject Neutrophils medicine.medical_treatment 030204 cardiovascular system & hematology Biochemistry law.invention Pulmonary function testing 03 medical and health sciences Leukocyte Count 0302 clinical medicine law medicine Cardiopulmonary bypass Humans Dexmedetomidine Cardiac Surgical Procedures Lung Mechanical ventilation Inflammation QH573-671 business.industry Thoracoscopy Tracheal intubation Cell Biology General Medicine Perioperative Exudates and Transudates Middle Aged Respiration Artificial Cardiac surgery Respiratory Function Tests Oxygen Intensive Care Units 030220 oncology & carcinogenesis Anesthesia Arterial blood Female business Pulmonary Ventilation Cytology Procalcitonin medicine.drug Research Article |
| Zdroj: | Oxidative Medicine and Cellular Longevity, Vol 2020 (2020) Oxidative Medicine and Cellular Longevity |
| ISSN: | 1942-0994 1942-0900 |
| Popis: | Objective. Totally thoracoscopic cardiac surgery under cardiopulmonary bypass combined with one-lung ventilation has been identified as the trend in cardiac surgery. The aim of this study was to examine the effects of the selective α2 adrenergic receptor agonist dexmedetomidine on the pulmonary function of patients who underwent mitral valve surgery using the totally thoracoscopic technique. Methods. Fifty-seven patients who underwent thoracoscopic mitral valve surgery between July 2019 and December 2019 were selected. The patients were randomly divided into the control (Con) group ( n = 28 ) and the dexmedetomidine (DEX) group ( n = 29 ) using the random number table method. Arterial blood gas analyses were performed, and the oxygenation (PaO2/FiO2) and respiratory indexes (P(A-a)O/PaO2) were calculated 5 min after tracheal intubation (T1), 2 h after operation (T2), 6 h after operation (T3), and 24 h after operation (T4). Moreover, the serum cytokines interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) were detected using the enzyme-linked immunosorbent method at all time points. Chest radiography was performed 24 h after surgery. Peripheral blood samples were collected before and after the operation for a complete hemogram. Additionally, the procalcitonin concentration was measured and recorded when the patients were transported to the intensive care unit (ICU). The postoperative extubation time, length of ICU stay, and pulmonary infection rate were also recorded. Results. Inflammatory reaction after surgery was evident. However, the inflammatory cytokines IL-6, TNF-α, and ICAM-1 in the DEX group were lower than those in the Con group after surgery (T2 to T4; P < 0.05 ). Neutrophil counts and procalcitonin concentration were higher in the Con group than in the DEX group ( P < 0.05 ). In addition, in the DEX group, pulmonary exudation on chest radiography was lower, and pulmonary function, as shown by an increase in oxidation index and decrease in the respiratory index, improved after surgery ( P < 0.05 ). Moreover, the duration of mechanical ventilation in the Con group was 3.4 h longer than that in the DEX group. Conclusion. Dexmedetomidine has a protective effect on pulmonary function in patients undergoing mitral valve surgery using a totally video-assisted thoracoscopic technique, which may be related to a reduction in the concentration of inflammatory cytokines in the early perioperative period. |
| Databáze: | OpenAIRE |
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