Previous Abstract | Next Abstract
Printable Version
A1007
October 22, 2016
10/22/2016 7:30:00 AM - 10/22/2016 9:00:00 AM
Room W474a
Chronic Hypertension and Systemic Inflammatory Response In Lung Resection Surgery. A Prospective Study
Patricia Pineiro, M.D.,Ph.D., Francisco De La Gala, M.D.,Ph.D., Ignacio Garutti, M.D.,Ph.D., Almudena Reyes Fierro, M.D.,Ph.D., Luis Olmedilla, M.D.,Ph.D., Elena Vara, M.D.,Ph.D., Carlos Simon, M.D.,Ph.D., Francisco Moraga, M.D., Guillermo Sanchez, M.D.,Ph.D., Lisa Rancan, M.D.
Hospital General Universitario Gregorio Mara[ent]#241;[ent]#243;n, Madrid, Spain
Disclosures:  P. Pineiro: None. F. De La Gala: None. I. Garutti: None. A. Reyes Fierro: None. L. Olmedilla: None. E. Vara: None. C. Simon: None. F. Moraga: None. G. Sanchez: None. L. Rancan: None.
BACKGROUND:

Chronic hypertension (HT) is one of the most common chronic medical conditions observed in preoperative evaluation. It´s known that these patients are at an increased risk of morbidity and mortality after surgery. An association between HT and inflammation has been clearly demonstrated. The main goal of our study was to evaluate the systemic inflammatory response in hypertensive patients undergoing lung resection surgery (LRS).

MATERIAL and METHODS:

174 patients who undergo LRS and voluntarily accept to participate in the study by giving their signed inform consent, were consecutively recruited. We classified patients as Non-HT (n=95); HT grade I (n=38), hypertensive patients preoperatively well controlled with one hypotensive drug; HT grade II (n=41) hypertensive patients who need two or more hypotensive drugs to control preoperative arterial blood pressure or patients who have had an hypertensive emergency during the previous 12 months. All the patients were managed with the same anesthetic protocol. Arterial blood was drawn for measurement of respiratory gases and inflammatory markers at 5 time points: baseline (before one-lung ventilation (OLV)); at 30 minutes after initiation of OLV; at the end of OLV; 6 and 18 hours after surgery. Release of inflammatory markers was measured using Western Blot.

In the postoperative period we recorded: Acute kidney injury, Respiratory failure, postoperative pulmonary and cardiac complications, length stay in intensive care unit and in hospital, death in the first postoperative year. We used an ANOVA test of variance to compare means in continuous data between three groups of patients. Also we use a Chi squared test to analyze differences between groups in categorical variables. Statistical significance was set at p<0.05.

RESULTS:

Tables 1 and 2 show patients characteristics, surgical data and respiratory and hemodynamic parameters. The systemic inflammatory response was higher at 6 hours postoperative in the hypertensive patients. Furthermore this increase was more pronounced in Grade II patients (Table 3). Preoperative HT was associated with a worse postoperative evolution (Table 4).

CONCLUSIONS:

Hypertensive patients developed a greater systemic inflammatory response than non-hypertensive patients after lung resection surgery. The inflammatory response was more pronounced in HT grade II. Postoperative outcome is related with the presence of preoperative HT and the severity of HT.
Figure 1
Figure 2
Figure 3
Figure 4

Copyright © 2016 American Society of Anesthesiologists