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Impact of a Lung-Protective Ventilatory Strategy on Systemic and Pulmonary Inflammatory Responses During Laparoscopic Surgery: Is It Really Helpful?

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Abstract

Laparoscopic surgery is performed by carbon dioxide (CO2) insufflation, but this may induce stress responses. The aim of this study is to compare the level of inflammatory mediators in patients receiving low tidal volume (VT) versus traditional VT during gynecological laparoscopic surgery. Forty American Society of Anesthesiologists (ASA) physical status 1 and 2 subjects older than 18 years old undergoing laparoscopic gynecological surgery were included. Systemic inflammatory response was assessed with serum IL-6, TNF-alpha, IL-8, and IL-1β in patients receiving intraoperative low VT and traditional VT during laparoscopic surgery [within the first 5 min after endotracheal intubation (T1), 60 min after the initiation of mechanical ventilation (T2), and in the postanesthesia care unit 30 min after tracheal extubation (T3)]. Additionally, inflammatory response was assessed with bronchoalveolar lavage (BAL) at T1 and T3 periods. An increase in the serum levels of IL-6, TNF-alpha, IL-8, and IL-1β was observed in both groups during the time periods of T1, T2, and T3. No significant differences were found in the serum and BAL levels of inflammatory mediators during time periods between groups. The results of the present study suggested that the lung-protective ventilation and traditional strategies are not different in terms of lung injury and inflammatory response during conventional laparoscopic gynecological surgery.

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Conflict of Interest

We declare that this study was financially supported by the Scientific Research Projects Committee, Rectorate of Afyon Kocatepe University, Afyonkarahisar, Turkey.

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Authors and Affiliations

  1. Department of Anaesthesiology and Reanimation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey

    Serdar Kokulu, Elif Doğan Baki, Yüksel Ela & Remziye Gül Sivaci

  2. Department of Pulmonary Medicine, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey

    Ersin Günay & Sevinc Sarinc Ulasli

  3. Department of Obstetrics and Gynaecology, Medical Faculty, Afyon Kocatepe University, Afyonkarahisar, Turkey

    Mehmet Yilmazer & Dagistan Tolga Arıöz

  4. Department of Medical Biochemistry, Medical Faculty, Afyon Kocatepe University, Afyonkarahisar, Turkey

    Buğra Koca

  5. Tip Fakultesi Hastanesi, Afyon Kocatepe Universitesi, Göğüs Hastalıkları A.D., 03200, Afyonkarahisar, Turkey

    Ersin Günay

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  1. Serdar Kokulu
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  2. Ersin Günay
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  3. Elif Doğan Baki
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  4. Sevinc Sarinc Ulasli
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  6. Buğra Koca
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  8. Yüksel Ela
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  9. Remziye Gül Sivaci
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Correspondence to Ersin Günay.

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Kokulu, S., Günay, E., Baki, E.D. et al. Impact of a Lung-Protective Ventilatory Strategy on Systemic and Pulmonary Inflammatory Responses During Laparoscopic Surgery: Is It Really Helpful?. Inflammation 38, 361–367 (2015). https://doi.org/10.1007/s10753-014-0039-3

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  • DOI: https://doi.org/10.1007/s10753-014-0039-3

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