Journal of Hebei Medical University

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Effects of dexmedetomidine on lung NF-κB expression and the plasma TNF-α as well as ICAM-1 levels in patients undergoing one lung ventilation

  

  1. 1.Department of Anesthesiology, the First Hospital of Hebei Medical University， Shijiazhuang
    050031, China; 2.Department of General Surgery, the People′s Hospital,
    of Pingshan County Hebei Province, Pingshan 050400, China
  • Online:2016-03-25 Published:2016-05-11

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Abstract: [
Abstract ] Objective Toobservetheeffectsofdexmedetomidineonlungnuclearfactor-κB
( NF-κB ) expressionandtheplasmatumornecrosisfactor-α ( TNF-α ) andintercellularadhesion
molecule-1 ( ICAM-1 ) levelsinpatientsundergoingonelungventilation ( OLV ) andtoinvestigate
themechanism oflungprotection.Methods Fortylungcancerpatientsscheduledforradical
operationwererandomlydividedinto2groups ( n =20ineachgroup ) byusingarandomnumber
table : controlgroupanddexmedetomidinegroup.Indexmedetomidinegroup , dexmedetomidine1
μ g
/ kgwasinfusedintraveineusly (
iv ) after10minanaesthesiainduction , andthenwasinfusedat
arateof0. 5 μ g ·
kg
-1 · h -1 until30minaheadoftheendofoperation.
Incontrolgroup , theequal volumeofnormalsalinewasinfused.Arterialbloodsampleswerecollectedimmediatelybefore
OLV ( T 1 ), 60minafterOLV ( T 2 ), 30minafterbilateralpulmonaryinflating ( T 3 ), 2hafter
operation ( T 4 ) and24hafteroperation ( T5 ) toobtainarterialbloodgasanalysisdata , oxygen
index ( OI ), respiratoryindex ( RI ), PaO 2 / PAO 2 andtodeterminelevelsofplasmaTNF-αand
ICAM-1.Lungtissueswereobtainedmorethan5cmawayfromtumoratthetimeoflobectomy
oflungsinordertodetermineNF-κBexpression.Results ThevaluesofOIandPaO 2 / PAO 2 were
decreasedatT 2 ~T 4 thanthatofatT 1 intwogroups.ThevaluesofOIandPaO 2 / PAO 2 were
increasedindexmedetomidinegroupcomparedtothatincontrolgroupatT 2 ~T 4 ( P <0.05 ) .The
valuesofRIwereincreasedatT 2 ~T 4 thanthatofatT 1 intwogroups , andweredecreasedin
dexmedetomidinegroupcomparedtothatincontrolgroupatT 2 ~T 4 ( P <0.05 ) .PlasmaTNF-α
and ICAM-1 levels showed ascending and descending trends , and were decreased in
dexmedetomidinegroupcomparedtothatincontrolgroupatT 2 ~T 4 ( P <0.05 ) .Theexpression
ofNF-κBwasincreasedindexmedetomidinegroupcomparedtothatincontrolgroup ( P <0.05 ) .
Conclusion Dexmedetomidinewith1 μ g / kgloadingdoseand0.5 μ g ·
kg
-1 · h -1 continuing
infusiondose during operation caninhibitactivation of NF-κB and reduce OLV induced
inflammatoryresponseaswellasimproveoxygenationfunctionandshowitslungprotection
roles.

Key words: pulmonary ventilation； dexmedetomidine, NFkappa B； chemokines