Discussion
pleural effusion, lung injury, atelectasis, lung cancer, ventilator-induced lung injury, pulmonary inflammation, hypoxic pulmonary vasoconstriction, ischemia-reperfusion injury, trauma
PLEURAL EFFUSION, METASTASIS, ATELECTASIS, LUNG CANCER, PULMONARY INFLAMMATION, OXIDATIVE STRESS, INCREASED ROS PRODUCTION
This randomized controlled trial demonstrated that TEAS could inhibit oxidative stress during OLV in patients with lung cancer, thereby improving oxygenation index and pulmonary diffusion function. Additionally, TEAS could shorten the postoperative ICU and hospital stay, and improve the QoR-15 score. These results revealed that the application of TEAS during OLV may benefit patients with lung cancer undergoing thoracic surgery.One-lung ventilation is a common ventilation method used in thoracic anesthesia for airway management, which could not only prevent cross-infection and metastasis of secretions and blood from the operated side to the healthy side lung but also create a clear surgical field. However, during lung resection and OLV, lots of factors, including ventilator-induced lung injury (VILI), hypoxic pulmonary vasoconstriction (HPV), ischemia-reperfusion injury, and surgical trauma, could lead to pulmonary mechanical and biochemical injuries. Up to date, a large number of studies had shown that oxidative stress was one of the key potential mechanisms underlying lung injury during OLV in thoracic surgery [As an innovative type of acupuncture therapy, TEAS transmitted a specific low-frequency pulse current to the body through electrodes, which had a similar effect to electroacupuncture. Previous research suggested that electroacupuncture may reverse pulmonary inflammation and oxidative damage in rats by reducing p38 phosphorylation along with caspase-3 activation [During one-lung ventilation, non-ventilated lung not only collapsed in alveoli but also decreased blood perfusion by 50% due to HPV and gravity, which directly led to vascular structure destruction and increased ROS production [PaOAdditionally, the incidence of pleural effusion and atelectasis was compared between the two groups. However, the duration of ICU stay and hospital stay after surgery was markedly reduced in the TEAS group, possibly due to reduced oxidative stress [There are some limitations in this study. The main limitation of our research was the relatively small study population. Considering the inherent bias of a small number of samples, the results of our study need to be confirmed by further research. Also, further research was needed to explore other possible protective mechanisms associated with TEAS.