Dexmedetomidine attenuates one‐lung ventilation associated lung injury by suppressing inflammatory responses: A systematic review and meta‐analysis

Bai, Yun-Xiao; Zhang, Jie-Han; Zhao, Bing-Cheng; Liu, Ke-Xuan; Bai, Yaowu

doi:10.1111/1440-1681.13525

Cited by 16 publications

(14 citation statements)

References 43 publications

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“…Perioperative application of DEX can reduce the inflammatory response caused by OLV and improve pulmonary oxygenation, which may help reduce the postoperative complications. 31 Taken together, these findings suggested a reduction in postoperative pulmonary complications in lung cancer patients treated with DEX.…”

Section: Discussionmentioning

confidence: 76%

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Zhou¹,

Xia

Zhang³

2022

Thorac Cardiovasc Surg

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Objective Lung cancer is a primary cause of cancer death. This study assessed the action of dexmedetomidine (DEX) on oxidative stress (OS) and microRNA 10a (miR-10a) in patients with lung cancer. Methods Patients were given 1 µg/kg DEX before anesthesia and control patients were given saline. The duration of intraoperative one-lung ventilation (OLV) and fluid intake were determined, and mean arterial pressure, heart rate and bispectral index were observed at the time of before anesthesia (T0), immediately after endotracheal intubation (T1), 1 hour after OLV (T2), and 10 minutes before the end of surgery (T3). The expressions and correlations of miR-10a, inflammation and OS levels in the serum were analyzed. The effects of DEX intervention and miR-10a level on pulmonary complications were analyzed. Results Patients with DEX intervention had lower levels of inflammation and OS during perioperative period than the controls. DEX intervention reduced miR-10a levels in patients during perioperative period. miR-10a in serum of patients with DEX intervention after surgery was positively-correlated with the concentrations of malondialdehyde, and inflammatory factors, while negatively-correlated with superoxide dismutase. The total incidence of postoperative pulmonary complications after DEX intervention was lowered. Patients with high miR-10a expression had a higher cumulative incidence of pulmonary complications than those with low miR-10a expression. Conclusion DEX can reduce postoperative OS and plasma miR-10a level in patients with lung cancer, and high expression of miR-10a predicts a high incidence of postoperative pulmonary complications.

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Section: Discussionmentioning

confidence: 76%

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Zhou¹,

Xia

Zhang³

2022

Thorac Cardiovasc Surg

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“…In recent years, evidence has emerged that DEX, a widely used anesthesia adjunct, exhibits numerous anti-inflammatory mechanisms with researches reporting benefits in multiple organ protection [ 30 , 31 ]. For example, DEX has been verified with potent protections in several cases of lung injury, such as ventilation-associated lung injury [ 24 ], ischemia/reperfusion injury [ 22 ], and endotoxin-induced acute injury [ 23 , 32 ]. In addition, our previous study has demonstrated that DEX was capable to attenuate airway inflammation in an ovalbumin-induced asthma model [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…A longitudinal midline incision was made to the neck to expose the trachea, and the trachea was cannulated and connected to the Flexivent system to ventilate at 160 breaths/min, 200 μl tidal. After the baseline of respiratory mechanics was recorded, mice were challenged with increasing doses of aerosolized methacholine (6,12,24, and 48 μg/g). Total respiratory resistance (Rrs) was recorded to assess the airway hyperresponsiveness.…”

Section: Measurement Of Lung Function and Methacholinementioning

confidence: 99%

“…Dexmedetomidine (DEX) is a highly selective α2 adrenergic receptor agonist that is widely used in the intensive care units and operating rooms [16]. In addition to the sedative and hypnotic properties, accumulating evidence reports that DEX has protective effects for the brain [17], heart [18,19], kidney [20,21], and lung [22][23][24]. However, it is unclear whether DEX can also protect against asthma.…”

Section: Introductionmentioning

confidence: 99%

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Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway

Zhou

Wang

et al. 2023

Mediators of Inflammation

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Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.

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“…In addition, dexmedetomidine reduces the inflammatory response during 1-lung ventilation, thereby reducing lung injury; this effect may be associated with improved intrapulmonary shunting in patients. [ 19 , 20 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane maintained during one-lung ventilation: A case–control study

Wang

Gong²,

Yu³

et al. 2022

Medicine

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Background: The effects of dexmedetomidine on the circulatory system are complex. It is difficult to predict its effects on intrapulmonary shunts and hypoxic pulmonary vasoconstriction in patients with one-lung ventilation. This study aimed to investigate the effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane during one-lung ventilation. Methods: Forty patients requiring thoracoscopic lobectomy were randomly divided into the dexmedetomidine group (Group D, n = 20) and the normal saline group (Group N, n = 20). The arterial partial pressure of oxygen (PaO2), pulmonary shunt fraction (Qs/Qt), mean end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were compared between the 2 groups at 3 time points: (i) after 5 minutes of two-lung ventilation (T0), (ii) after 30 minutes of one-lung ventilation (OLV) (T1), and (iii) after 45 minutes of OLV (T2). The dosage of sevoflurane from the beginning of OLV to T2 was calculated. Results: There were no significant differences in age, body mass index, and FEV1/FVC between Groups D and N (P > .05). At T0, T1, and T2, the PaO2 levels of Group D and Group N were similar (P > .05), and the PaO2 levels of Group D and Group N decreased after OLV. The Qs/Qt level of Groups D and N were similar at T0 (P > .05), and the level of Groups D and N at T1 and T2 was higher than that at T0. The Qs/Qt of Group D was statistically significantly lower than that of Group N at T1 and T2 (P < .05). Conclusion: Compared with the control group, we found that dexmedetomidine can reduce the intrapulmonary shunt fraction and improve the body’s status during OLV.

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Dexmedetomidine attenuates one‐lung ventilation associated lung injury by suppressing inflammatory responses: A systematic review and meta‐analysis

Cited by 16 publications

References 43 publications

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway

Effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane maintained during one-lung ventilation: A case–control study

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