ORIGINAL RESEARCH article
Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Impact of Individualized Tidal Volume Strategies on Intraoperative Lung Protection and and Inflammatory Markers in Laparoscopic Cholecystectomy: a randomized controlled trial
Provisionally accepted
- 1The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- 2Hohhot First Hospital, Hohhot, China
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Objective: The aim of this study is to evaluate the impact of individualized tidal volume settings, as compared to conventional settings on lung injury in patients undergoing laparoscopic cholecystectomy under mechanical ventilation. Methods: A total of 40 patients scheduled for elective laparoscopic cholecystectomy at the Affiliated Hospital of Inner Mongolia Medical University between August 2024 and January 2025 were enrolled in this randomized study. Participants were randomly assigned using a random number table to either the control group (Group C, n = 20) or the experimental group (Group T, n = 20), based on the method of tidal volume adjustment. Group C received a conventional tidal volume of 8 ml/kg. In Group T, resting tidal volume was measured preoperatively and used to individualize the mechanical ventilation settings. Serum levels of HTI56, surfactant protein A (SP-A), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured at T1 (prior to anesthesia) and T4 (6 hours postoperatively). Mean arterial pressure (MAP) and heart rate (HR) were recorded at four time points: T1(baseline), T2 (20 minutes post-intubation), T3 (40 minutes post-intubation), and T4(6 hours postoperatively). Airway parameters including peak airway pressure (Ppeak), plateau pressure (Pplat), and mean airway pressure (Pmean) were documented at T2 and T3. Results: The average delivered tidal volume in Group T was lower than that in Group C (6.2 ± 0.5 ml/kg vs. 8.0 ± 0.3 ml/kg), indicating a statistically significant difference (p < 0.05). At T4, serum levels of IL-6, TNF-α, HTI56, and SP-A were elevated in both groups compared to preoperative values. However, the increases in these inflammatory markers were significantly greater in Group C than in Group T (p < 0.05). However, there were no significant differences between the two groups in respiratory mechanics parameters, including Ppeak, Pplat, and Pmean (p > 0.05). Conclusion: Individualized tidal volume settings were associated with significantly lower postoperative elevations of IL-6, TNF-α, HTI56, and SP-A compared to conventional settings. These findings suggest that tailoring tidal volume based on resting respiratory parameters may help mitigate lung capillary barrier injury by attenuating the inflammatory response, thereby enhancing pulmonary protection during mechanical ventilation.
Keywords: HTI56, individualized tidal volume, Lung protection, mechanical ventilation, SP-A
Received: 01 Aug 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Wang, Hao and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li-Fang Wu, wulifangwlfnj@163.com
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