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document
Therapeutic effect of inhaled budesonide ( Pulmicort® Turbuhaler ) on the inflammatory response to one-lung ventilation . This prospective , double-blind trial was designed to evaluate the effect of inhaled budesonide on lung function and the inflammatory response to one-lung ventilation . One hundred patients scheduled for lobectomy were allocated randomly to pre-operative nebulised budesonide or saline . Bronchoalveolar lavage fluid samples were collected from either the collapsed or the ventilated lung both before one-lung ventilation and 30 min after re-expansion of the lung . The concentrations of serum and bronchoalveolar lavage fluid cytokines were determined . Budesonide treatment , compared with saline , reduced both peak ( mean ( SD ) 3.7 ( 0.4 ) vs 2.5 ( 0.2 ) kPa ) and plateau ( mean ( SD ) 3.1 ( 0.2 ) vs 2.2 ( 0.1 ) kPa , respectively , p < 0.001 for both ) ventilatory pressures . Thirty minutes after re-expansion , lung compliance increased in the budesonide group compared with saline ( 57.5 ( 4.1 ) vs 40.1 ( 3.5 ) ml.cmH ( 2 ) O ( -1 ) , respectively p < 0.001 ) . Budesonide also reduced the concentrations of tumour necrosis factor-α , interleukin-1β , interleukin-6 and interleukin-8 in bronchoalveolar lavage fluid , but increased interleukin-10 30 min after re-expansion ( p < 0.05 for all measures ) . Pre-operative nebulisation of budesonide may be effective in improving ventilatory mechanics and reducing the inflammatory response to one-lung ventilation during thoracic surgery .
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Intervention_Pharmacological
budesonide
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Intervention_Pharmacological
budesonide
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Intervention_Pharmacological
saline
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Outcome_Physical
lung function
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Outcome_Physical
inflammatory
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Outcome_Physical
serum and bronchoalveolar lavage fluid cytokines
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Outcome_Physical
ventilatory pressures
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Outcome_Physical
concentrations of tumour necrosis factor-α , interleukin-1β , interleukin-6 and interleukin-8 in bronchoalveolar lavage fluid
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Outcome_Physical
interleukin-10
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Outcome_Physical
ventilatory mechanics
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Outcome_Physical
inflammatory response
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Participant_Sample-size
One hundred