Effect of Goal-Directed Fluid Therapy on Lung Function, Cognitive Function and Inflammatory Response in Patients Undergoing Radical Esophageal Cancer Surgery under One-Lung Ventilation
- 1 Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 2 Department of Critical Care Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 3 Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 4 Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 5 Operation Room, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 6 Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
- 7 Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
Abstract
Objective: To explore the effects of goal-directed fluid therapy (GDFT) on lung function, cognitive function and inflammatory response in patients undergoing radical esophageal cancer surgery under one-lung ventilation. Methods: Sixty-seven patients undergoing radical esophageal cancer surgery were divided into GDFT group (GDFT therapy) and control group (conventional liquid therapy). The changes in patients ’ pulmonary function, cognitive function and inflammatory response were evaluated. Results: Both alveolar-arterial oxygen partial pressure difference [P(A-a)O 2 ] and respiratory index (RI) increased at one-lung ventilation for 30 minutes (T 2 ) and decreased at one-lung ventilation for 60 minutes (T 3 ), and after surgery (T 4 ) in the two groups, and the GDFT group was lower than the control group (P < 0.05); theoxygenation index (OI) of the two groups decreased at T 2 , T 3 , and T 4 compared with that at T 1 (before one-lung ventilation), and the GDFT group was higher than the control group (P < 0.05). At T 4 and T 5 , the tumor necrosis factor α (TNF- α ), interleukin 6 (IL-6), central nervous system specific protein (S100 β ), and neuron specific enolase (NSE) in the GDFT group were lower compared to the control group (P < 0.05), while interleukin-10 (IL-10) was higher compared to the control group (P < 0.05); the incidence of perioperative neurocognitive disorder (PND) in the GDFT group was lower than that in the control group (P < 0.05). Conclusion: GDFT can help prevent lung injury during radical esophageal cancer surgery under one-lung ventilation, reduce the body ’ s inflammatory response, and reduce the incidence of perioperative cognitive disorder to a certain extent.
- Arslan-Carlon, V., Tan, K.S., Dalbagni, G., Pedoto, A.C., Herr, H.W., Bochner, B.H., Cha, E.K., Donahue, T.F., Fischer, M. and Donat, S.M. (2020) Goal-Directed versus Standard Fluid Therapy to Decrease Ileus after Open Radical Cystectomy: A Prospective Randomized Controlled Trial. Anesthesiology, 133, 293-303. https://doi.org/10.1097/ALN.0000000000003367
- Xu, C., Jiang, C., et al. (2019) Intelligence and Treatment Progress of Neurocognitive Intelligence during Perioperative Period. Critical Care Medicine, 31, 159-162.
- Qin, H., Chen, H., Liu, S., et al. (2020) Effect of Nabuyin on Neurocognitive Impairment in Patients with One-Lung Surgery. Chinese Journal of New Drugs and Clinical Remedies, 39, 36-40.
- Zhang, P., Wu, L. and Lu, X. (2019) Research Progress of Hemodynamic Monitoring and Surgical Management in Thoracic Surgery. Journal of Chinese Physician, 21, 158-162.
- Zhang, N., Liang, M., Zhang, D.D., Xiao, Y.R., Li, Y.Z., Gao, Y.G., Cai, H.D., Lin, X.Z., Lin, C.Z., Zeng, K. and Wu, X.D. (2018) Effect of Goal-Directed Fluid Therapy on Early Cognitive Function in Elderly Patients with Spinal Stenosis: A Case-Control Study. International Journal of Surgery, 54, 201-205. https://doi.org/10.1016/j.ijsu.2018.04.007
- Marioni, R.E., Chatfield, M., Brayne, C. and Matthews, F.E. (2011) Medical Research Council Cognitive Function and Ageing Study Group. The Reliability of Assigning Individuals to Cognitive States Using the Mini Mental-State Examination: A Population-Based Prospective Cohort Study. BMC Medical Research Methodology, 6, Article No. 127. https://doi.org/10.1186/1471-2288-11-127
- Wang, P., Yue, C., Wang, H., et al. (2020) Initial Efficacy of Intensity-Modulated Radiotherapy for Esophageal Cancer and Analysis of Influencing Factors of Acute Radiation Lung Injury. Advances in Modern Biomedicine, 20, 183-187.
- Lin, M., Shen, Y., Feng, M. and Tan, L. (2019) Is Two Lung Ventilation with Artificial Pneumothorax a Better Choice than One Lung Ventilation in Minimally Invasive Esophagectomy? Journal of Thoracic Disease, 11, S707-S712. https://doi.org/10.21037/jtd.2018.12.08
- Joosten, A., Delaporte, A., Ickx, B., Touihri, K., Stany, I., Barvais, L., Van Obbergh, L., Loi, P., Rinehart, J., Cannesson, M. and Van der Linden, P. (2018) Crystalloid versus Colloid for Intraoperative Goal-Directed Fluid Therapy Using a Closed-Loop System: A Randomized, Double-Blinded, Controlled Trial in Major Abdominal Surgery. Anesthesiology, 128, 55-66. https://doi.org/10.1097/ALN.0000000000001936