Back ground and Goal of Study: Lung Resection Surgery (LRS) with One Lung Ventilation (OLV) is associated with an intense local and systemic inflammatory response (SIR)1. The aim of this work was to study the effects of the
administration of inhalated sevoflurane on the SIR during LRS with OLV and on the shedding of lung-endotelial glycocalyx2.
Materials and methods: 20 swine were dividen en 4 groups, 5 animals each. 10 animals underwent to left caudal lobectomy: Group CONTROL (CON) received propofol (8-10 mg kg -1 h -1) and Group SEVOFLURANE (SEVO). 2 additional procedures were perfomed in 2 groups with the same methodology as in the CON group but without
lobectomy nor OLV (SHAM-A), and without lobectomy but with OLV (SHAM-B). After the procedure the animales were awaken and 24 h., later were again anesthetized.
TNF-alpha, IL-1, cathepsine B, syndecan-1 and heparan sulfate protein expression were gathered through Western Blot analysis in blood samples, at 30 minutes OLV, 120 minutes OLV, 60 minutes two-lung ventilation and 24
hours. Monitoring include parametres derived of PiCCO system (cardiac output, extravascular lung water, global end diastolic volume and sistolic volume variation).
Differences between groups were analysed by ANOVA multiple range test and Wilcoxon test for evolution of the intragroup values. P values < 0.05 were considered.Results and discussion: OLV can by itself promote a SIR after LRS. Sevoflurane use has demonstrated to attenuate inflammatory response and the shedding of lung-endotelial glycocalix in lung resection surgery.
References:
1. Schilling T et al. The pulmonary immune effects of mechanical ventilation in patients undergoing thoracic surgery. Anesth Analg 2005;101:957-65.
2.Schmidt EP et al. The circulating glycosaminoglycan signature of respiratory failure in critically ill adults. J Biol Chem 2014; 289: 8194-202.

Sevoflurane attenuates systemic inflammatory response and shedding of lung-endothelial glycocalix in lung resection surgery and one lung ventilation in an experimental model animal