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Air in the insufflation tube may cause fatal embolizations in laparoscopic surgery: an animal study.
MedLine Citation:
PMID:  23239303     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the risk of an air embolization with the volume of the insufflation tube during induction of laparoscopy. A further objective was to determine the LD(50) of air in young piglets. METHODS: End-tidal carbon dioxide pressure ([Formula: see text]), pulmonary arterial pressure (P (pa)), heart rate (f (c)), and mean arterial pressure (P (a carot)) were measured in 17 piglets divided into three groups: group 1 (n = 6), bolus application (CO(2) embolization, followed by air embolization, 2 mL/kg each), group 2 (n = 7), continuous air embolization (30 min, 0.2 mL/kg/min), and group 3 (n = 4), continuous CO(2) embolization (30 min, 0.4 mL/kg/min). RESULTS: All animals survived CO(2) embolism. Air embolization as a bolus (2 mL/kg) or with an accumulated volume of 3.1 mL/kg led to death. Decreases in [Formula: see text] indicated air or massive CO(2) embolization only. There was a good correlation between [Formula: see text] and P (pa) in case of air embolization (r = -0.80, p < 0.0001). In contrast, no dependency was recognized during CO(2) embolism (r = -0.17, p = 0.2). CONCLUSIONS: In order to minimize the lethal risk of gas embolization, the insufflation system has to be completely filled with CO(2) before connecting to the patient.
Authors:
Steffen Richter; Christine Matthes; Till Ploenes; Devrim Aksakal; Tobias Wowra; Thomas Hückstädt; Felix Schier; Christoph Kampmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-13
Journal Detail:
Title:  Surgical endoscopy     Volume:  -     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatric Surgery, University Medical Center, Mainz, Germany, steffen@richter-chirurgie.de.
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