Effect Of Mucosolvan Pretreatment On Intrapulmonary Shunt And Oxygenation During One-lung Ventilation In Patients Undergoing Esophageal Cancer Resection

Objective pulmonary shunt is the main cause of hypoxemia during one-lung ventilation.A variety of external stimuli cause pulmonary injury.Because of pulmonary injury,pulmonary inflammatory response can become worse.Because of the excessive activation of white blood cells and waterfalls cascade of cytokine,the lung is damaged and the function of systemic immune is changed,then lead to damage.At last,the occurrence of atelectasis increased.Reduce pulmonary shunt is the most effective methods to reduce the inflammatory response.Mucosolvan is a new generation of phlegm liquid solute.In recent years there have been many studies have showed that mucosolvan have the effect of lung protecting except expectorant.Because of antioxidation action and antiinfammatory action,mucosolvan can alleviate lung injury.In this research,we just to investigate the changes in arterial oxygenation and intrapulmonary shunt during one-lung ventilation(OLV)with intravenous infusion of mucosolvan.Methods ASA I-II 100 patients aged 30-64 year,undergoing OLV during elective esophageal surgery were randomly allocated to two groups:(n=50 each): mucosolvan group(group M)and normal saline group(group NS).Mucosolvan 5mg/kg was infused intravenously 30 min before induction in group M,as the equal volume of normal saline was infused instead of mucosolvan in group NS.Keep a record of MAP,HR,Sp02 and Pmean at 10 min of two—lung ventilation(To),at 35 min of one—lung ventilation(T1),and at 30 min after expansion of the collapsed lung(T2).Blood samples from jugular vein and radial artery were for blood gas analysis and then intrapulmonary shunt(QS/QT)was calculated.Results Hemodynamic variables or depth of anesthesia did not significantly differ between groups(P>0.05).Administration of mucosolvan significantly reduced Qs/Qt and increased Pa O after OLV.Conclusion Mucosolvan pretreatment can improve oxygenation and reduce the intrapuhnonary shunt during one—lung ventilation in patients undergoing esophageal cancer resection,so mucosolvan have the effect of lung protection.