Abstract:

Objective To investigate the expression of Calgranulin A（S100A8） in serum during lobectomy under different ventilation modes. Methods Twenty patients with lung cancer who underwent pulmonary lobectomy were divided into one-lung ventilation group and two-lung ventilation group according to different ventilation modes，with 10 cases in each group. The operation time，anesthe-sia time，total infusion volume，oxygenation index，recovery time，extubation time，sputum suction times，pneumonia，atelectasis，hospi-tal stay and death were recorded. Western blot was used to detect the expression of S100A8 in the patients serum in the two groups before operation （T0），at the end of operation （T1），24 hours after operation （T2） and 48 hours after operation （T3）. Results There were no significant differences in operation time，anesthesia time，total infusion volume，recovery time，extubation time，sputum suction times，pneumonia cases，atelectasis cases and death cases between the two groups（P>0.05）. The oxygenation index in one-lung ventilation group was significantly lower than that in two-lung ventilation group ［（296.20±77.64） mmHg vs  （319.20±30.23） mmHg，t=2.189，P=0.042］，and the hospital stay increased significantly ［（7.80±1.87） d vs （6.20±1.48） d，t=2.121，P=0.048］. There was no significant difference in the expression of S100A8 between one-lung ventilation group and two-lung ventilation group before operation（P>0.05）. Repeated variance analysis showed that there was significant difference among the groups with different ventilation modes（F=310.76，P<0.001）. The trend of change over time was different（F=24.85，P=0.025）. There was interaction between the time and time point（F=18.85，P=0.001）. Conclusions The intraoperative oxygenation index of lung cancer patients undergoing thoracotomy with one-lung ventilation is lower than that with two-lung ventilation，and the expression of S100A8 is higher，which may be related to the higher incidence of ventilator-associated lung injury.

Key words: Lung neoplasms, One-lung ventilation, Two-lung ventilation, S100A8 protein, Ventilator-induced lung injury