Document Detail


Cardiopulmonary changes during laparoscopy and vessel injury: comparison of CO2 and helium in an animal model.
MedLine Citation:
PMID:  11131248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Injury of venous vessels during elevated intraperitoneal pressure is thought to cause possible fatal gas embolism, and helium may be dangerous because of its low solubility. METHODS: Twenty pigs underwent laparoscopy with either CO2 (n=10) or helium (n=10) with a pressure of 15 mm Hg and standardized laceration (1 cm) of the vena cava inferior. After 30 s, the vena cava was clamped, closed endoscopically by a running suture and unclamped again. During the procedure changes of cardiac output (CO), heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary artery wedge pressure (PAWP), end tidal CO2 pressure (PETCO2), and arterial blood gas analyses (pH, pO2 and pCO2) were investigated. RESULTS: No animal died during the experimental course (mean blood loss during laceration: CO2, 157+/-50 ml; helium, 173+/-83 ml). MAP and CO values showed a decrease after laceration of the vena cava in both groups that had already been completely compensated for before suturing. PETCO2 increased significantly after CO2 insufflation (P<0.01), while helium showed no effect. Laceration of the vena cava caused no significant changes in PETCO2 values in either group. Significant acidosis and an increase of pCO2 were only found in the CO2 group. CONCLUSIONS: The incidence of gas embolism during laparoscopy and accidental vessel injury seems to be very low. With the exception of acidosis and an increase of PETCO2 in the CO2 group, there were no differences in cardiopulmonary function between insufflation of CO2 and helium.
Authors:
C A Jacobi; T Junghans; F Peter; D Naundorf; J Ordemann; J M Müller
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie     Volume:  385     ISSN:  1435-2443     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-22     Completed Date:  2001-02-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  459-66     Citation Subset:  IM    
Affiliation:
Department of Surgery, Humboldt--University of Berlin, Germany. christoph.jacobi@charite.de
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MeSH Terms
Descriptor/Qualifier:
Animals
Carbon Dioxide
Embolism, Air / etiology*
Helium
Hemodynamics*
Lacerations
Laparoscopy* / adverse effects
Models, Animal*
Pneumoperitoneum, Artificial*
Random Allocation
Swine
Vena Cava, Inferior / injuries
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7440-59-7/Helium

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


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