Pressure and volume controlled ventilation during olv evaluation of the effect of lipid peroxidation

During operations and surgical procedures for the lungs to expand the field of view in order to facilitate one-lung ventilation (OLV) has been frequently used. OLV, although a portion can be applied safely in the majority of patients develop hypoxemia. Hypoxemia are known to increase the formation of freee oxygen radicals. Free oxygen radicals cause damage to tissues and organs through several mechanisms. The end product of lipid peroxidation associated with oxygen free radicals is that malondialdehyde (MDA), is often used as an indicator of lipid peroxidation. For the prevention of tissue and organ damage due to free oxygen radical studies have recently been increasing. We are in this study, pressure-controlled ventilation and volume-controlled ventilation during one-lung ventilation aimed to evaluate on lipid peroxidation. Approval from the Ethics committee of the University started to work with the Mediterranean. Patients were informed about the study voluntarily sign an informed consent form. 34 cases were included. In this study, two patients were excluded because of double-lumen endotracheal tube malposition. Subjects were evaluated in the operating room, electrocardiogram and oxygen saturation monitored after iv. premedication with midazolam. Artery cannula inserted under local anesthesia, arterial blood pressures were monitored. Haemodynamic effects, mechanical ventilatory parameters, duration of ventilation and the SpO2 values were recorded. Preoperative evaluation of malondialdehyde and blood gas measurements in arterial blood samples were taken. Induction of anesthesia with fentanyl, thiopental and maintained with vecuronium. Maintenance of anesthesia, fentanyl, vecuronium, sevoflurane and dry air and oxygen mixture. Double-lumen endobronchial intubation was performed with the tube. Double-sided position of the tube was confirmed by auscultation. Patients were randomly as a volume-controlled (17 cases), and pressurecontrolled (15 cases) were divided into two groups. MDA measurements to assess arterial kataterinden patients preoperatively, immediately before the start of OLV, OLV at the end, and 6 hours after surgery, blood samples were taken biochemistry tube. Measurement of MDA levels: MDA adduct OxiSelect assayed by ELISA using ELISA kit. The data obtained were analyzed using the SPSS version 18. PCV and VCV groups, smoking and not found a significant association between changes serum MDA (p> 0.05). Both groups were examined between the groups in terms of cigarette use of PCV compared with VCV group was found to use more cigarettes (p = 0.014). PCV values of MDA as a result of comparison between groups than in VCV group had lower MDA TAV BAŞ found a statistically significant (p = 0.026). PCV and VCV groups, OLV FiO2 value at the beginning, with OLV at the beginning of a statistically significant relationship was found between MDA levels (p> 0.05). PCV and VCV groups, one-lung ventilation-intubation in the period up to the beginning, FiO2 (51±3.8% and 55±13.2%, respectively) applied to be TLV, provides a significant increase in PaO2 and SpO2 values were compared to preoperative measurements. PCV and VCV groups, there was no significant difference between the values of OLV during the FiO2 (p> 0.05). PCV and VCV groups, PaO2 and SpO2 values at the end of OLV although there is no statistical difference between the value of MDA at the end of OLV with VCV group no significant correlation between PaO2 and SpO2 values (p <0.05), the PVC group, there was no such relationship. The beginning of OLV; PaO2 and SpO2 values are decreased by the end of OLV. The beginning of OLV; MDA value by the value of MDA was lower than at the end of OLV. PCV and VCV groups, OLV at the beginning of the level of serum MDA, than preoperative serum MDA levels were significantly lower. VCV group, serum MDA levels at the end of OLV, than preoperative serum MDA levels were higher. PCV and VCV groups in serum MDA levels were increased significantly relative to the start of OLV at the end of OLV (p <0.05). At 6 hours after the operation of serum MDA levels were statistically significant increased than preoperative serum levels of MDA. PCV and VCV groups were compared with a statistically significant difference was found between the values of PaCO2 (p> 0.05). PCV and VCV groups were compared with a statistically significant difference was found between the values of PaO2 (p> 0.05). PCV and VCV groups were compared with a statistically significant difference was found between the values of SpO2 (p> 0.05). PCV and VCV groups were compared with a statistically significant difference was found between the values of plato pressure (p> 0.05). PCV and VCV groups, peak pressures were evaluated by peak pressure in the PCV group, 15 and 30 minutes after the start of OLV is lower than VCV group the values found statistically significant (p <0.05). As a result, measurements of serum MDA in both groups at the end of OLV, OLV were significantly higher than the beginning. During the OLV, PCV and VCV groups, respectively 86.6±22.8 and 82.4%±18.7% mean FiO2 ratio was observed to prevent implementation of the hypoxia. However, by the use of high concentrations of oxygen in the lungs, may be damaged due to oxygen free radical. PCV and VCV groups, TLV during the respectively applied 51±3.8%, 55±13.2% FiO2 values were PaO2 was a significant increase pressure. In contrast, a significant decrease in serum MDA level was observed. The improvement of tissue oxygenation appears to reduce lipid peroxidation. In both groups, intubation time previous to the beginning of OLV by the value of MDA was lower than the preoperative value. But PCV group, serum MDA level were found to be lower. With this result, pressure controlled ventilation during two-lung ventilation to reduce lipid peroxidation was concluded that more than volume-controlled ventilation. MDA levels were increased in both group during the OLV. With this result, the OLV is applied during the PCV and VCV modes, we consider that the different effects on lipid peroxidation. MDA levels in blood samples taken at shorter intervals during the OLV with a more accurate assessment of outcomes will be in.