Acute Lung Injury(ALI)
Conditions
Keywords
Dexmedetomidine, Aquaporins, Lung Function, One-lung ventilation
Brief summary
This randomized controlled trial evaluated the dose-dependent effects of dexmedetomidine (DEX) on pulmonary function and aquaporin-1 (AQP1) expression during one-lung ventilation (OLV) in thoracoscopic surgery.
Interventions
DRUGdexmedetomidine 0.3 µg/kg/h
Following Anesthesia induction, dexmedetomidine (DEX) Low Dose group received a DEX loading dose (0.5 µg/kg over 10 min), followed by continuous infusions of 0.3 µg/kg/h, respectively, until 30 minutes before the end of the operation.
DRUGdexmedetomidine 0.5 µg/kg/h
Following Anesthesia induction, dexmedetomidine (DEX) high dose group received a DEX loading dose (0.5 µg/kg over 10 min), followed by continuous infusions of 0.5 µg/kg/h, respectively, until 30 minutes before the end of the operation.
DRUG0.9 % saline
Placebo group received an equivalent volume of 0.9% saline.
Sponsors
People's Hospital of Guangxi Zhuang Autonomous Region
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists (ASA) physical status I or II * Age 40-70 years * Body mass index (BMI) 18-30 kg/m²
Exclusion criteria
* Preoperative tumor radiotherapy or chemotherapy * Immune or endocrine disorders * Hepatic or renal dysfunction * Preoperative corticosteroid use * Recent respiratory infection or chronic lung disease * Sick sinus syndrome or atrioventricular block * Preoperative anemia (hemoglobin \< 90 g/L)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| aquaporin-1 (AQP1) expression during one-lung ventilation in thoracoscopic surgery | before one-lung ventilation, Immediately after lobectomy | AQP1 expression, serving as an indicator of pulmonary interstitial water permeability, was assessed by immunohistochemistry (IHC) on lung tissue samples. Two histologically normal specimens (1×1×1 cm³ each) were collected per patient: 1) Before one-lung ventilation: ≥ 5 cm from tumor margin in planned resection area; 2) Immediately after lobectomy: ≥ 5 cm from margin in isolated lung. Tissues were fixed in 10% neutral buffered formalin (24 hours), paraffin-embedded, and sectioned (3 μm). Five random high-power fields (HPF, 400x) per section were evaluated. The percentage of positive cells (0: 0-25%; 1: 26-50%; 2: 51-75%; 3: 76-100%) and staining intensity (0: none; 1: light yellow; 2: brown; 3: dark brown) were scored. The total IHC score (range 0-9) was calculated as (percentage score x intensity score); specimens were classified as low (≤ 4) or high (\> 4) AQP1 expression. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pulmonary function during one-lung ventilation in thoracoscopic surgery, including lung compliance (Cdyn) | pre-dexmedetomidine administration, 60 minutes, 90 minutes, 120 minutes after one-lung ventilation initiation, and 30 minutes after reinstitution of two-lung ventilation | Radial arterial blood samples were drawn for blood gas analysis at the specified time points. Dynamic lung compliance (Cdyn) was recorded from the anesthesia machine. |
| Pulmonary function during one-lung ventilation in thoracoscopic surgery, including respiratory index (RI), and oxygenation index (OI). | pre-dexmedetomidine administration, 60 minutes, 90 minutes, 120 minutes after one-lung ventilation initiation, and 30 minutes after reinstitution of two-lung ventilation | Radial arterial blood samples were drawn for blood gas analysis at the specified time points. The respiratory index (RI) and oxygenation index (OI) were calculated as: RI=P(A-aDO2)/PaO2=\[(Pb-PH2O) × FiO2-PaO2-PaCO2/RQ\]/PaO2. OI= PaO2/FiO2. P(A-aDO2) - alveolar-arterial blood oxygen partial pressure difference, PaCO2 - partial arterial pressure of CO2, Pb - barometric pressure (760 mmHg), pH2O - partial pressure of water vapor (47 mmHg), RQ - respiratory quotient (0.8). |
Countries
China
Outcome results
None listed