Document Detail


Intestinal perfusion during pneumoperitoneum with carbon dioxide, nitrogen, and nitric oxide during laparoscopic surgery.
MedLine Citation:
PMID:  10688221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To find out what effect insufflation pressure and type of gas have on intestinal perfusion during pneumoperitoneum. DESIGN: Randomized, controlled, prospective, experimental study. SETTING: University affiliated animal experimental laboratory, Sweden. ANIMALS: Fasted, anaesthetised, domestic pigs of both sexes operated on laparoscopically (n = 7, weight 26-31 kg). INTERVENTIONS: Insufflation of carbon dioxide (CO2), nitric oxide (NO), or nitrogen (N2) at intra-abdominal pressures of 0, 5, 10, 15 and 20 mm Hg. MAIN OUTCOME MEASURES: Cardiac output, portal blood flow, and jejunal mucosal perfusion. RESULTS: Cardiac output decreased during N2 and NO (15, 20 mm Hg) but not during CO2 insufflation because of an accompanying tachycardia. Portal flow decreased during insufflation with N2 and NO (15, 20 mm Hg) and CO2 (20 mm Hg). Jejunal perfusion was reduced during N2 and NO insufflation (5-20 mm Hg) but remained unchanged during CO2 insufflation (5-20 mm Hg). CONCLUSIONS: Insufflation with CO2 maintained jejunal mucosal perfusion, probably as a result of hypercarbia as N2 at equal pressures reduced mesenteric flow. The vasodilator NO provided no haemodynamic benefit.
Authors:
A Aneman; M Svensson; O Stenqvist; J Dalenbäck; H Lönnroth
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European journal of surgery = Acta chirurgica     Volume:  166     ISSN:  1102-4151     ISO Abbreviation:  Eur J Surg     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-04-05     Completed Date:  2000-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9105264     Medline TA:  Eur J Surg     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  70-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / physiology
Animals
Carbon Dioxide*
Cardiac Output
Female
Gases
Guinea Pigs
Insufflation
Intestinal Mucosa / blood supply*
Jejunum
Laparoscopy
Male
Microcirculation
Nitric Oxide*
Nitrogen*
Pneumoperitoneum, Artificial*
Portal Vein / physiology
Pressure
Regional Blood Flow
Chemical
Reg. No./Substance:
0/Gases; 10102-43-9/Nitric Oxide; 124-38-9/Carbon Dioxide; 7727-37-9/Nitrogen

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


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