Koksal Guniz M, Dikmen Yalim, Erbabacan Emre, Aydin Seval, Çakatay Ufuk, Sitar Mustafa Erinc, Altindas Fatis
Department of Anesthesiology and Reanimation, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, 34040, Istanbul, Turkey.
Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, 34040, Istanbul, Turkey.
J Anesth. 2016 Aug;30(4):610-9. doi: 10.1007/s00540-016-2164-7. Epub 2016 Mar 21.
The hypothesis of our study is that during anesthesia, administration of 80 % oxygen concentration increases oxidative stress more than 40 % oxygen.
Forty ASA I-II patients were included in a randomized, single-blind study. Expiratory tidal volumes (ETV) were measured before induction and after extubation. After ventilation with 0.8 FiO2 and intubation, mini-bronchoalveolar lavage (mini-BAL), arterial blood gas (ABG), and blood samples were taken. Patients were randomly assigned to receive 0.8 (group I) or 0.4 (group II) FiO2 during management. Before extubation, mini-BAL, ABG, blood samples were taken. PaO2/FiO2, lactate, malondialdehyde (MDA), protein carbonyl (PCO), superoxide dismutase (SOD), total sulfhydryl (T-SH), non-protein sulfhydryl (NPSH), and protein sulfhydryl (PSH) were measured. In both groups, mean arterial pressure and heart rate values were recorded with 30-min intervals.
ETV values were higher in group II after extubation. PaO2/FiO2 values were higher in group II after extubation compared to group I. In both groups, plasma PCO, SOD, and T-SH levels increased significantly before extubation, whereas the increase in MDA was not significant between groups. Plasma PCO, T-SH, and lactate levels were higher in group I, and plasma SOD, and PSH were higher in group I before extubation. In both groups, MDA, SOD, T-SH, and NPSH levels in mini-BAL increased significantly before extubation. Between-group comparisons, PCO, T-SH, PSH, and NPSH were significantly higher in the BAL samples of group II, and MDA levels were higher in group I.
We found that 80 % FiO2 decreased ETV and PaO2/FiO2 and increased lactate levels and oxidative stress more, inhibiting antioxidant response compared to 40 % FiO2.
我们研究的假设是，在麻醉期间，给予80%氧浓度比40%氧浓度会增加更多的氧化应激。
40例美国麻醉医师协会（ASA）分级为I-II级的患者纳入一项随机、单盲研究。在诱导前和拔管后测量呼气潮气量（ETV）。在给予0.8的吸入氧分数（FiO2）并插管后，进行小型支气管肺泡灌洗（mini-BAL）、采集动脉血气（ABG）和血样。患者在管理期间被随机分配接受0.8（I组）或0.4（II组）的FiO2。在拔管前，进行小型支气管肺泡灌洗、采集动脉血气和血样。测量动脉血氧分压/吸入氧分数（PaO2/FiO2）、乳酸、丙二醛（MDA）、蛋白质羰基（PCO）、超氧化物歧化酶（SOD）、总巯基（T-SH）、非蛋白质巯基（NPSH）和蛋白质巯基（PSH）。在两组中，每隔30分钟记录平均动脉压和心率值。
II组拔管后的ETV值更高。与I组相比，II组拔管后的PaO2/FiO2值更高。在两组中，拔管前血浆PCO、SOD和T-SH水平显著升高，而两组间MDA的升高不显著。I组拔管前血浆PCO、T-SH和乳酸水平更高，血浆SOD和PSH在I组更高。在两组中，拔管前小型支气管肺泡灌洗中的MDA、SOD、T-SH和NPSH水平显著升高。组间比较，II组BAL样本中的PCO、T-SH、PSH和NPSH显著更高，I组的MDA水平更高。
我们发现，与40%的FiO2相比，80%的FiO2会降低ETV和PaO2/FiO2，更多地增加乳酸水平和氧化应激，抑制抗氧化反应。
