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Effect of a protective-ventilation strategy on systemic inflammation after esophagectomy: A-1

Michelet, P.; Roch, A.; Djourno, B.; Decamps, I.; Thomas, P.; Auffray, J. P.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 1
ESA Best Abstract Prize Competition (BAPC)

Département dAnesthésie Réanimation, Hôpital Sainte Marguerite, Marseille, France

Background and Goal of Study: Esophagectomy is characterised by a marked postoperative inflammatory reaction. The mechanical ventilation (MV) including a prolonged period of one-lung ventilation (OLV) could influence the peri-operative systemic inflammatory response. The aim of this prospective, randomised study was to compare two ventilatory strategies on the systemic peri-operative pro-inflammatory response.

Materials and Methods: 50 patients undergoing a radical esophagectomy were randomly assigned into a conventional MV group [tidal volume of 9ml · kg−1 during two and one-lung ventilation, no positive end-expiratory pressure (PEEP)] or a protective MV group [tidal volume of 9 ml · kg−1 during two-lung ventilation and 5 ml · kg−1 during OLV, PEEP 5 cmH2O]. Successive arterial blood samples for IL-1 β, IL-6 and IL-8 levels were taken after induction of anesthesia (Time A), 15 minutes after the end of abdominal time (Time B), two (Time C) and 18 hours (Time D) after the end of surgical procedure.

Results and Discussions: Data (Mean ± SD) are shown in the table.



Conclusion(s): In patients undergoing esophagectomy, a protective ventilatory strategy lead to a decrease in peri-operative systemic pro-inflammatory response.

© 2005 European Society of Anaesthesiology