Effects of sevoflurane preconditioning on lung injury during one lung ventilation.

BACKGROUND: To study the lung protective effects of heme oxygenase-1 (HO-1) expression and sevoflurane preconditioning in patients with lobectomy.

METHODS: 30 patients receiving lobectomy were divided into two groups: propofol intravenous anesthesia group (Pro group) and sevoflurane preconditioning group (Sev group). In Pro group, propofol was used for intravenous anesthetic. In Sev group, 1%-2% sevoflurane was used during anesthesia induction to one lung ventilation (OLV). Venous blood was taken before OLV (T1), at the end of OLV (T2) and at 30 min after lung ventilation (T3) to measure the concentration of serum malondialdehyde (MDA) in two groups. HO-1 protein and mRNA expression in resected lung tissue were measured with PT-PCR and Western blot technique. Oxygenation index was detected at 2 hours after operation.

RESULTS: HO-1 protein (2.88±0.23 ng/ml) and mRNA expression in Sev group were significantly higher compared to protein (1.89±0.12 ng/ml)and mRNA expression in Pro group (P<0.05). Difference was not found in MDA concentration at T1 compared to T2 (P>0.05), however, at T3, MDA concentration was higher in Pro group than that in Sev group (P<0.05). oxygenation index in Sev group was 380±67 mmHg, which was significantly different from that in Pro group (290±56 mmHg) (P<0.05).

CONCLUSION: Sevoflurane preconditioning can reduce oxidative stress injury induced by OLV and protect lung tissue by increasing HO-1 expression in lung tissue.