Effect Of Lung Protective Ventilation Strategy On CC16 Expression In Patients Undergoing One-Lung Ventilation

Objective:To evaluate the effect of lung protective ventilation strategy on CC16expression in patients with one lung ventilation by detecting serum CC16 level,and to provide theoretical basis for lung protective ventilation strategy to reduce lung injury.Methods:Fifty patients undergoing elective thoracoscopic lobectomy were selected for general anesthesia with double-lumen endotracheal intubation and one-lung ventilation.Patients were randomly divided into traditional ventilation group（NLPV group）and lung protective ventilation group（LPV group）with 25 cases each.The parameters of NLPV group were:VT 10 ml/kg,ventilation frequency 10-15 times,PEEP<5 cmH₂O,no lung recruitment.The parameters of LPV group were:VT6 ml/kg,ventilation frequency 10-15times/min,PEEP5-10 cmH₂O,one pulmonary resuscitation in two hours,keeping plateau pressure<35 cmH₂O.Blood gas analysis was performed before induction（T₁）,immediately after one-lung ventilation（T₂）,30 minutes（T₃）,before extubation（T₄）and24 hours（T₅）.The PaO₂ and PaCO₂ levels were recorded and the index（RI）was recorded.Blood and the levels of serum TNF-alpha,IL-6 and CC16 were measured.The postoperative complications of the two groups were recorded.Statistical analysis was carried out to obtain the results of the study.Results:There was no significant difference in PaCO₂ between LPV group and NLPV group at different time points（P>0.05）,and there was no significant difference in PaO₂and RI between the two groups at T₁and T₅ time points（P>0.05）.But,the PaO₂ of LPV group was significantly higher than that of NLPV group at time points of T₂,T₃ and T₄,and the RI of LPV group at time points of T₂,T₃ and T₄ was significantly lower than that of NLPV group（P<0.05）.There was no significant difference in TNF-a,IL-6 and CC16between the two groups at T₁ time point（P>0.05）.However,the levels of TNF-a,IL-6and CC16 at T₂,T₃,T₄ and T₅ in LPV group were significantly lower than those in NLPV group,with statistical significance（P<0.05）.However,there was no significant difference in the incidence of postoperative complications between the two groups（P>0.05）.Conclusion:Pulmonary protective ventilation strategy can improve arterial oxygenation index in patients with one-lung ventilation.It can effectively inhibit the expression of inflammatory cytokines,and decrease the level of serum CC16.