Background: Compared to conventional tidal volume ventilation, low tidal-volume ventilation reduces mortality\nin cased of acute respiratory distress syndrome. The aim of the present study is to determine whether low\ntidal-volume ventilation reduces the production of inflammatory mediators in the lungs and improves\nphysiological status during hepatic surgery.\nMethods: We randomly assigned patients undergoing hepatectomy into 2 groups: conventional tidal-volume\nvs. low tidal-volume (12 vs. 6 mLââ?¬Â¢kgâË?â??1 ideal body weight) ventilation with a positive end-expiratory pressure of\n3 cm H2O. Arterial blood and airway epithelial lining fluid were sampled immediately after intubation and every\n3 h thereafter.\nResults: Twenty-five patients were analyzed. No significant changes were found in hemodynamics or acidââ?¬â??base\nstatus during the study. Interleukin-8 was significantly elevated in epithelial lining fluid from the low tidal-volume\ngroup. Oxygenation evaluated immediately after admission to the post-surgical care unit was significantly worse\nin the low tidal-volume group.\nConclusions: Low tidal-volume ventilation with low positive end-expiratory pressure may lead to pulmonary\ninflammation during major surgery such as hepatectomy.
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