Hyperoxia during one lung ventilation: inflammatory and oxidative responses

Pediatr Pulmonol. 2012 Oct;47(10):979-86. doi: 10.1002/ppul.22517. Epub 2012 Mar 19.

Abstract

Background: It is common practice during one lung ventilation (OLV) to use 100% oxygen, although this may cause hyperoxia- and oxidative stress-related lung injury. We hypothesized that lower oxygen (FiO(2) ) during OLV will result in less inflammatory and oxidative lung injury and improved lung function.

Methods: Twenty pigs (8.88 ± 0.84 kg; 38 ± 4.6 days) were assigned to either the hyperoxia group (n = 10; FiO(2) = 100%) or the normoxia group (n = 10; FiO(2) < 50%). Both groups were subjected to 3 hr of OLV. Blood samples were tested for pro-inflammatory cytokines and lung tissue was tested for these cytokines and oxidative biomarkers.

Results: There were no differences between groups for partial pressure of CO(2) , tidal volume, end-tidal CO(2) , plasma cytokines, or respiratory compliance. Total respiratory resistance was greater in the hyperoxia group (P = 0.02). There were higher levels of TNF-α, IL-1β, and IL-6 in the lung homogenates of the hyperoxia group than in the normoxia group (P ≤ 0.01, 0.001, and 0.001, respectively). Myeloperoxidase and protein carbonyls (PC) were higher (P = 0.03 and P = 0.01, respectively) and superoxide dismutase (SOD) was lower in the lung homogenates of the hyperoxia group (P ≤ 0.001).

Conclusion: Higher myeloperoxidase, PC, and cytokine levels, and lower SOD availability indicate a greater degree of injury in the lungs of the hyperoxia animals, possibly from using 100% oxygen. In this translational study using a pig model, FiO(2) ≤ 50% during OLV reduced hyperoxic injury and improved function in the lungs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Lung Injury / enzymology
  • Acute Lung Injury / etiology
  • Acute Lung Injury / physiopathology
  • Animals
  • Carbon Dioxide / blood
  • Cytokines / blood
  • Hyperoxia / blood
  • Hyperoxia / etiology*
  • Hyperoxia / physiopathology*
  • Inflammation / blood
  • Inflammation / physiopathology*
  • Lung / enzymology
  • Lung / physiology*
  • One-Lung Ventilation / adverse effects*
  • Oxidative Stress*
  • Oxygen / adverse effects*
  • Peroxidase / analysis
  • Protein Carbonylation / physiology
  • Superoxide Dismutase / analysis
  • Swine

Substances

  • Cytokines
  • Carbon Dioxide
  • Peroxidase
  • Superoxide Dismutase
  • Oxygen