Document Detail

Reduction of CO(2)-pneumoperitoneum-induced metabolic hypoxaemia by the addition of small amounts of O(2) to the CO(2) in a rabbit ventilated model. A preliminary study.
MedLine Citation:
PMID:  12042288     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: CO(2)-pneumoperitoneum used in endoscopic surgery induces system effects by CO(2) absorption. This study investigated the effect of the addition of O(2) to CO(2)-pneumoperitoneum, upon CO(2) absorption. METHODS: The effect of a pneumoperitoneum using 100% CO(2) or 94% CO(2) + 6% O(2) upon arterial blood gases, acid base and O(2) homeostasis was evaluated. In series A suboptimal ventilation and a pneumoperitoneum pressure (PP) of 10 mmHg was used. In series B adequate ventilation and PP of 6 mmHg was used. RESULTS: CO(2)-pneumoperitoneum profoundly affected blood gases and acid base homeostasis i.e. increasing pCO(2), HCO(3)(P < 0.001) and lactate concentrations (P < 0.05) and decreasing pH, actual base excess and standard bicarbonate (P < 0.001), resulting in metabolic hypoxaemia with desaturation, lower pO(2) (P < 0.001) and O(2)Hb (P < 0.05). These effects were more pronounced with higher PP and suboptimal ventilation. CONCLUSION: CO(2)-pneumoperitoneum profoundly affected blood gases and acid base homeostasis resulting in metabolic hypoxaemia. The addition of 6% of O(2) to the CO(2)-pneumoperitoneum prevented these effects to a large extent. If these preliminary data are confirmed in the human, the addition of a few percent of O(2) to CO(2) could become important for endoscopic surgery of long duration, especially in obese patients with limited cardiorespiratory adaptation and steep Trendelenburg.
Ospan A Mynbaev; Carlos R Molinas; Leila V Adamyan; Bernard Vanacker; Philippe R Koninckx
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  17     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-03     Completed Date:  2003-01-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  1623-9     Citation Subset:  IM    
Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium.
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MeSH Terms
Anoxia / etiology,  prevention & control*
Carbon Dioxide / adverse effects*
Endoscopy / adverse effects,  methods
Models, Animal
Oxygen / administration & dosage
Pneumoperitoneum, Artificial / adverse effects,  methods*
Respiration, Artificial
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comment In:
Hum Reprod. 2003 Apr;18(4):890; author reply 891   [PMID:  12660293 ]

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