Document Detail


Carbon dioxide absorption and gas exchange during pelvic laparoscopy.
MedLine Citation:
PMID:  1394755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Twelve ASA physical status I-II patients undergoing pelvic laparoscopy for infertility were enrolled in a study to quantify the effects of CO2 insufflation and the Trendelenburg position on CO2 elimination and pulmonary gas exchange, and to determine the minute ventilation required to maintain normocapnia during CO2 insufflation. Measurements of O2 uptake (VO2), CO2 elimination (VCO2), minute ventilation (VE), FIO2, and respiratory exchange ratio (RQ) were made during three steady states: control (C) taken after 15 min of normoventilation but before CO2 insufflation, after 15 min (L1) and 30 min (L2) of hyperventilation during CO2 insufflation. The FIO2 was controlled at 0.5 and arterial blood gases were used to calculate the oxygen tension-based indices of pulmonary gas exchange. After 15 min and 30 min of CO2 insufflation, the volume of CO2 absorbed from the peritoneal cavity was estimated at 42.1 +/- 5.1 and 38.6 +/- 6.6 (SEM) ml.min-1 respectively, increasing CO2 elimination through the lungs by about 30%. Hyperventilation of the lungs by a 20-30% increase in minute ventilation maintained normocapnia. Despite the CO2 pneumoperitoneum and Trendelenburg position, there was no impairment of pulmonary oxygen exchange as estimated by (A-alpha)DO2. This study demonstrated that a 30% increase in minute ventilation, achieved by increasing tidal volume to more than 10 ml.kg-1, is sufficient to eliminate the increased CO2 load and maintain normal pulmonary O2 exchange during pelvic laparoscopy.
Authors:
P L Tan; T L Lee; W A Tweed
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  39     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-10-29     Completed Date:  1992-10-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  677-81     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, National University Hospital, National University of Singapore.
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MeSH Terms
Descriptor/Qualifier:
Absorption
Adult
Carbon Dioxide / pharmacokinetics*
Female
Humans
Infertility, Female / diagnosis*
Laparoscopy*
Pelvis
Posture
Pulmonary Gas Exchange / physiology*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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