Effect Of Lung Recruitment Maneuvers On Serum SP-A、VWF And Blood Gas In One-lung Ventilation Patients

Objective:To evaluate the effects of lung recruitment maneuvers (RM) on the serum concentration of pulmonary surfactant associated protein-A(SP-A),von Willebrand factor (VWF),malondialdihyde (MDA) and blood gas in one-lung ventilation (OLV) patients.Methods:Forty patients undergoing radical resection of lung cancer were randomly divided into 2 groups (n=20 each):lung recruitment maneuvers group (group R) and control group (group C).RM was used in Group R at two lung ventilation (TLV) 5min and after recovery of TLV 5min.RM method:10 consecutive manual ventilation at an airway peak pressure of 40 cmH2O,each ventilation lasts 5 seconds; followed by 5min TLV using 15cmH2O PEEP. The radial artery samples were collected for blood gas analysis and alveolar dead space calculation at five time points:after induction of anesthesia (To),TLV15min (Ti), OLV20min (T2),OLV60min (T3) and 15min after recovery of TLV (T4).Blood samples were taken from central vein for determination of the serum SP-A,VWF,MDA concentrations at three time points:T0,2h after operation (T5) and 24h after operation (T6).Results:Compared with group C,PaO2 at T1-T4 were increased in group R(P< 0.05);alveolar dead space rate at T1-T4 were decreased in group R(P<0.05); PaCO2 at T1,T4 were decreased in group R(P<0.05).Compared with group C. serum SP-A concentration at T.6 was decreased in group R (P< 0.05). Serum VWF concentration was no differences between the two groups (P> 0.05). Compared with To, serum MDA concentration were increased at T5, T6 (P< 0.05); Serum MDA concentration were no significant difference between the two groups(P>0.05).Conclusion:RM has the effects of improving ventilation efficiency and lung protection through decreasing alveolar dead space and decreasing serum SP-A concentration in OLV patients.