The Relationship of One Lung Ventilation (OLV) Technique to Troponin T and I Levels in Thoracic Surgical Procedures

Postoperative myocardial infarction is a significant complication with varying incidence depending on the type of surgery and the patient's risk factors. In major surgery, the incidence of PMI ranged from 0.37-2.4%, with a 30-day mortality rate of 1.04% (Huang et al., 2020). The PMI risk increases gradually with additional risk factors, ranging from 0.42% for one risk factor to 1.08% for three or more risk factors. Important risk factors associated with PMI include a history of previous myocardial infarction, where surgery performed within 8 weeks after MI significantly increases the risk of PMI and postoperative mortality. Thoracic surgery is one of the complex surgical procedures that requires special anesthesia management to facilitate optimal surgical access to the intrathoracic structure. The one lung ventilation (OLV) technique has become standard in thoracic surgical anesthesia, allowing lung collapse on the surgical side thus providing better visualization and surgical access. Although this technique provides significant operative advantages, OLV can give rise to a variety of physiological complications that have the potential to affect a patient's cardiovascular function.
Troponin T and troponin I are the most sensitive and specific cardiac biomarkers for detecting myocardial injury. These two structural proteins are exclusively found in the heart muscle and are released into the circulation when myocardial cell damage occurs, even at a subclinical level. Elevated troponin levels may indicate a procedure-related myocardial injury or perioperative myocardial infarction, both of which are associated with increased postoperative morbidity and mortality. This study aims to determine the relationship of the One Lung Ventilation (OLV) technique to Troponin T and I Levels in Thoracic Surgery Procedures at Prof. Dr. Margono Soekarjo Purwokerto Hospital.