Flurbiprofen axetil increases arterial oxygen partial pressure by decreasing intrapulmonary shunt in patients undergoing one-lung ventilation.

Abstract

PURPOSES:

In the present study, we investigated whether flurbiprofen axetil (FA) alleviates hypoxemia during one-lung ventilation (OLV) by reducing the pulmonary shunt/total perfusion (Q s/Q t) ratio, and examined the relationship between the Q s/Q t ratio and the thromboxane B2 (TXB2)/6-keto-prostaglandin F1α (6-K-PGF1α) ratio.

METHODS:

Sixty patients undergoing esophageal resection for carcinoma were randomly assigned to groups F and C (n = 30 for each group). FA and placebo were administered i.v. 15 min before skin incision in groups F and C, respectively. The partial pressure of arterial oxygen (PaO2) was measured and the Q s/Q t ratio was calculated. Serum TXB2, 6-K-PGF1α, and endothelin (ET) were measured by radioimmunoassay. The relationship between TXB2/6-K-PGF1α and Q s/Q t was investigated.

RESULTS:

Compared with group C, PaO2 was higher and the Q s/Q t ratio was lower during OLV in group F (P < 0.05). After treatment with FA, both serum TXB2 and 6-K-PGF1α decreased significantly (P < 0.05) but the TXB2/6-K-PGF1α ratio increased significantly (P < 0.01). Increases in the TXB2/6-K-PGF1α ratio were correlated with reductions in the Q s/Q t ratio during OLV in group F (r = -0.766, P < 0.01). There was no significant difference in serum ET between groups F and C.

CONCLUSIONS:

Treatment with FA reduced the Q s/Q t ratio and further increased the PaO2 level during OLV, possibly due to upregulation of the vasoactive agent TXB2/6-K-PGF1α ratio.

• Authors: Xiao-Qing Chai, Jun Ma, Yan-Hu Xie, Di Wang, Kun-Zhou Chen
• Journal: Journal of anesthesia (J Anesth) Vol. 29 Issue 6 Pg. 881-6 (Dec 2015) ISSN: 1438-8359 [Electronic] Japan
• PMID: 26272250 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Thromboxane B2
• Flurbiprofen
• flurbiprofen axetil
• Oxygen

Topics

• Aged
• Blood Gas Analysis
• Female
• Flurbiprofen (administration & dosage, analogs & derivatives, pharmacology)
• Humans
• Lung (metabolism)
• Male
• Middle Aged
• One-Lung Ventilation (methods)
• Oxygen (blood)
• Partial Pressure
• Thromboxane B2 (blood)