In conclusion, VT of 6 mL·kg−1 predicted body weight ventilation with a PEEP of 3 cmH2O during hepatectomy caused inflammation in the airway and reduced oxygenation after the surgery, whereas VT of 12 mL·kg−1 ventilation with a PEEP of 3 cmH2O did not. There appears to be more lung inflammation with low tidal volume with low PEEP, which may be due to repeated alveolar collapse and re-expansion (i.e., atelectrauma). Our study supports the findings of other investigations looking at lung protective ventilation during surgery, mainly that low PEEP levels may be harmful. Careful consideration is warranted when enforcing a lung-protective strategy during major surgery.
ANOVA, analysis of variance; ARDS, acute respiratory distress syndrome; BAL, broncho-alveolar lavage; BGA, blood gas analysis; BMS, bronchoscopic microsampling; DF, dilution factor; ELF, epithelial lining fluid; ELISA, enzyme-linked immunosorbent assay; FIO2, inspired oxygen fraction; I/E, the ratio of the duration of inspiration to the duration of expiration; ICAM-1, intercellular adhesion molecule-1; IL, interleukin; PaCO2, arterial partial carbon dioxide pressure; PACU, post-anesthetic care unit; PaO2, arterial partial oxygen pressure; PEEP, positive end-expiratory pressure; PMN, polymorphonuculear cell; TNF, tumor necrosis factor; TV12, patients ventilated with a VT of 12 mL per predicted body weight; TV6, patients ventilated with a VT of 6 mL per predicted body weight; VT, tidal volume
We thank the doctors in the Department of Anesthesiology and the Department of Gastroenterological Surgery, Yokohama City University Hospital, Yokohama, Japan for their helpful assistance.
This work was supported by the Center for Advanced Medical Promotion of the Yokohama City University Graduate School of Medicine (grant number: 07-021) and the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (grant number: 26462368).
Availability of data and material
Data supporting our findings are available upon request.
Consent for publication
Ethics approval and consent to participate
This study was reviewed and approved by the review board of Yokohama City University (Date of IRB approval: 08-01-2007; approval number: 07-021), and all the patients provided written, informed consent preoperatively.
The effect of ventilatory tidal volume on lung injury during hepatectomy that requires transient liver blood flow interruption. UMIN000021371 (03/07/2016); retrospectively registered
BMC Anesthesiol. 2016;16(47) © 2016 BioMed Central, Ltd.