Cargando…

Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs

Carbon dioxide embolism is a rare but potentially devastating complication of laparoscopy. To determine the effects of insufflation pressure on the mortality from carbon dioxide embolism, six swine had intravascular insufflation with carbon dioxide for 30 seconds using a Karl Storz insufflator at a...

Descripción completa

Detalles Bibliográficos
Autores principales: Nagao, K., Reichert, J., Beebe, D.S., Fowler, J.M., Belani, K.G.
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 1999
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015330/
https://www.ncbi.nlm.nih.gov/pubmed/10444005
_version_ 1782195487629115392
author Nagao, K.
Reichert, J.
Beebe, D.S.
Fowler, J.M.
Belani, K.G.
author_facet Nagao, K.
Reichert, J.
Beebe, D.S.
Fowler, J.M.
Belani, K.G.
author_sort Nagao, K.
collection PubMed
description Carbon dioxide embolism is a rare but potentially devastating complication of laparoscopy. To determine the effects of insufflation pressure on the mortality from carbon dioxide embolism, six swine had intravascular insufflation with carbon dioxide for 30 seconds using a Karl Storz insufflator at a flow rate of 35 mL/kg/min. The initial insufflation pressure was 15 mm Hg. Following recovery from the first embolism, intravascular insufflation using a pressure of 20 mm Hg at the same flow rate was performed in the surviving animals. Significantly less carbon dioxide (8.3 ± 2.7 versus 16.7 ± 3.9 ml/kg; p < 0.02) was insufflated intravascularly at 15 mm Hg than at 20 mm Hg pressure. All of the pigs insufflated at 15 mm Hg pressure with a flow rate of 35 mL/kg/min survived. In contrast, 4 of the 5 pigs insufflated at 20 mm Hg pressure died. The surviving pig died when insufflated with 25 mm Hg pressure following an embolism of 15.7 ml/kg. Intravascular injection was often associated with an initial rise in end-tidal carbon dioxide tension, followed by a rapid fall in all cases where the embolism proved fatal. Insufflation should be begun with a low pressure and a slow flow rate to limit the volume of gas embolized in the event of inadvertent venous cannulation. Insufflation should immediately be stopped if a sudden change in end-tidal carbon dioxide tension occurs.
format Text
id pubmed-3015330
institution National Center for Biotechnology Information
language English
publishDate 1999
publisher Society of Laparoendoscopic Surgeons
record_format MEDLINE/PubMed
spelling pubmed-30153302011-02-17 Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs Nagao, K. Reichert, J. Beebe, D.S. Fowler, J.M. Belani, K.G. JSLS Scientific Papers Carbon dioxide embolism is a rare but potentially devastating complication of laparoscopy. To determine the effects of insufflation pressure on the mortality from carbon dioxide embolism, six swine had intravascular insufflation with carbon dioxide for 30 seconds using a Karl Storz insufflator at a flow rate of 35 mL/kg/min. The initial insufflation pressure was 15 mm Hg. Following recovery from the first embolism, intravascular insufflation using a pressure of 20 mm Hg at the same flow rate was performed in the surviving animals. Significantly less carbon dioxide (8.3 ± 2.7 versus 16.7 ± 3.9 ml/kg; p < 0.02) was insufflated intravascularly at 15 mm Hg than at 20 mm Hg pressure. All of the pigs insufflated at 15 mm Hg pressure with a flow rate of 35 mL/kg/min survived. In contrast, 4 of the 5 pigs insufflated at 20 mm Hg pressure died. The surviving pig died when insufflated with 25 mm Hg pressure following an embolism of 15.7 ml/kg. Intravascular injection was often associated with an initial rise in end-tidal carbon dioxide tension, followed by a rapid fall in all cases where the embolism proved fatal. Insufflation should be begun with a low pressure and a slow flow rate to limit the volume of gas embolized in the event of inadvertent venous cannulation. Insufflation should immediately be stopped if a sudden change in end-tidal carbon dioxide tension occurs. Society of Laparoendoscopic Surgeons 1999 /pmc/articles/PMC3015330/ /pubmed/10444005 Text en © 1999 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Nagao, K.
Reichert, J.
Beebe, D.S.
Fowler, J.M.
Belani, K.G.
Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title_full Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title_fullStr Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title_full_unstemmed Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title_short Carbon Dioxide Embolism During Laparoscopy: Effect of Insufflation Pressure in Pigs
title_sort carbon dioxide embolism during laparoscopy: effect of insufflation pressure in pigs
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015330/
https://www.ncbi.nlm.nih.gov/pubmed/10444005
work_keys_str_mv AT nagaok carbondioxideembolismduringlaparoscopyeffectofinsufflationpressureinpigs
AT reichertj carbondioxideembolismduringlaparoscopyeffectofinsufflationpressureinpigs
AT beebeds carbondioxideembolismduringlaparoscopyeffectofinsufflationpressureinpigs
AT fowlerjm carbondioxideembolismduringlaparoscopyeffectofinsufflationpressureinpigs
AT belanikg carbondioxideembolismduringlaparoscopyeffectofinsufflationpressureinpigs