Protective effects of ulinastatin on postoperative lung injury in different periods of one lung ventilation

Xiao Gang; Gu Lianbing; Wan Meifang; Gu Xiaolan

doi:10.3760/cma.j.issn.1673-4777.2014.11.007

Abstract：Objective To evaluate the pulmonary protective effects of ulinastatin during different periods of one lung ventilation(OLV) in esophageal carcinoma patients undergoing esophagectomy.Methods Forty-five patients(ASA Ⅰ-Ⅱ)undergoing esophogectomy with OLV were randomly divided into 3 groups with 15 cases in each group.The patients in group A and B had ulinastatin 5kU/kg(diluted with 50ml saline water,10min driping out) at the beginning or the end of OLV,and those in group C received same volume saline water without using ulinastatin.We recorded the ages,weights,duration of OLV,time of operation and loss of blood.Artery blood-gas analysis was performed before induction of anaesthesia (T0),before OLV (T1),at 1 h of OLV(T2),at the end of OLV(T3),at the end of operation(T4) and 2h after operation (T5).The blood samples were also taken at T0,T2-T5 for the measurements of TNF-α,and ET-1.Results Compared with group C,the levels of PaO2 were significantly higher at T2-T3 in group A [(215 ± 66) mmHg,(256 ± 78) mmHg vs (129 ± 39) mmHg,(183 ± 57) mmHg,P ＜ 0.05].The PaO2 at T4-T5 was also higher in both A and B group than in C group,but the differences were not obvious.The levels of TNF-α and ET-1 were increased in group C after beginning of OLV,and they were remarkably higher at T5 than at T0[(384 ± 105)ng/L,(176 ±87)ng/L vs (167 ±65)ng/ L,(76 ±20)ng/ L,P ＜0.01].The levels of TNF-α and ET-1 in group B were obviously lower at T4 than at T3 [(225 ± 94) ng/L,(124 ±70)ng/ Lvs (316±109)ng/ L,(140 ± 57) ng/ L,P＜0.05],but also higher than at T0[(162±57)ng/L,(74± 15] ng/ L).Compared with group C,the level of TNF-α,ET-1 were obviously lower at every points in group A; they were also lower at T5 in B group.Conclusion Ulinastatin can improve artery PaO2during the period of OLV and reduce the level of TNF-α and ET-1 after the operation,which would benefit the recovery of postoperative pulmonary function.