The Effects Of 6% Hydroxyethyl Starch 130/0.4 Compared With Polygeline On The Inflammatory Response Of Lungs In Patients With Lung Cancer Undergoing Lobectomy

Objective: To investigate the effects of 6% hydroxyethyl starch 130/0.4 and polygeline ,used as a plasma volume expander ,on the inflammatory response, oxidative Stress and respiratory function .Methods: Twenty ASAâ…¡patients with lung cancer, aged 45⁷4yr, undergoing lobectomy were randomly divided into two groups (n=10 each): 6% hydroxyethyl starch 130/0.4 group(group A) and polygeline group(group B) . The patients weren't given any drug before anesthesia. Perioperative monitoring included electrocardiogram,heart rate, invasive mean arterial blood pressure, systolic blood pressure, diastolic arterial blood pressure, peripheral oxygen saturation, heart rate variability, bispectral index and PETCO2. Anesthesia was induced with fentanyl 0.4μg/kg, propofol 2mg/kg. rocuronium 0.6mg/kg. After tracheal intubation,the patients were mechanically ventilated. Internal jugular vein was cannulated for CVP monitoring.6% hydroxyethyl starch 130/0.4 or polygeline 10ml/kg was infused iv at a rate of 0.67ml·kg^-1·min^-1 after induction of anesthesia. One-lung ventilation (OLV) were performed(VT 8ml/kg ,I:E with 1:1.5,oxygen flow rate 1.5L/min). PETCO2 was maintained at 35⁴5mmHg, the peak voltage of air tube was undered 35 cmH2O. During operation BIS was maintained at 40⁴5 with propofol and remifentanil .Blood samples were taken from radial and internal jugular ,blood gas analysis and determination plasma IL-6,IL-8,IL-10,SOD,MDA, SP-A concentration at after intubation (T₀),0.5h(T₁) and 1h(T₂) of OLV,0.5h of TLV (T₃)again.The differences in the variables measured between radial and internal jugular. Respiratory index(RI) and Oxygenation index(OI) were calculated.Results: There was no significant difference in the age of patients, during of surgery, colloidal volume and crystal volume.There was no significant difference in IL-6n,IL-8n,IL-10n,SODn,MDAn,RI and OI at T0 between the 2 groups. IL-6n,IL-8n,IL-10n,SODn and MDAn were significantly increased at T1-3 compared with the baselines at T0,and all indexes ,except IL-10n ,were higher in group B than in group A.There was no significant difference in RI and OI between the 2 groups. RI was significantly increased and OI was decreased at T_1-2 compared with the baselines at T₀.Conclusions: 6% hydroxyethyl starch 130/0.4 can reprove the inflammatory response, oxidative stress in patients with lung cancer undergoing lobectomy compared with polygeline, but there are no significant differences in RI and OI between 2 groups.