Inclusion of a Nitric Oxide Congener in the Insufflation Gas RepletesS-Nitrosohemoglobin and Stabilizes Physiologic Status During Prolonged Carbon Dioxide Pneumoperitoneum
| Autor: | W B A Samuel Belknap, Kazufumi Shimazutsu, F B S Matthew Baldwin, Jonathan S. Stamler, J B S Deborah McClaine, C B S Maximilian Jones, W. Steve Eubanks, J B S Rebecca McClaine, James D. Reynolds, Kenichiro Uemura, M B A Kathryn Auten, Francisco La Banca |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Time Factors Sus scrofa Hemodynamics Kidney Nitric Oxide General Biochemistry Genetics and Molecular Biology Renal Circulation Nitric oxide Hemoglobins chemistry.chemical_compound Pneumoperitoneum medicine Animals Splanchnic Circulation General Pharmacology Toxicology and Pharmaceutics Blood urea nitrogen Research Articles Nitrites Renal circulation Ethyl nitrite General Neuroscience Insufflation General Medicine Carbon Dioxide Hydrogen-Ion Concentration medicine.disease Oxygen medicine.anatomical_structure chemistry Creatinine Anesthesia Renal blood flow Female Blood Gas Analysis Perfusion |
| Zdroj: | Clinical and Translational Science. 2:405-412 |
| ISSN: | 1752-8062 1752-8054 |
| DOI: | 10.1111/j.1752-8062.2009.00154.x |
| Popis: | A method to maintain organ blood flow during laparoscopic surgery has not been developed. Here we determined if ethyl nitrite, an S-nitrosylating agent that would maintain nitric oxide bioactivity (the major regulator of tissue perfusion), might be an effective intervention to preserve physiologic status during prolonged pneumoperitoneum. The study was conducted on appropriately anesthetized adult swine; the period of pneumoperitoneum was 240 minutes. Cohorts consisted of an anesthesia control group and groups insufflated with CO2 alone or CO2 containing fixed amounts of ethyl nitrite (1-300 ppm). Insufflation with CO2 alone produced declines in splanchnic organ blood flows and it reduced circulating levels of S-nitrosohemoglobin (i.e., nitric oxide bioactivity); these reductions were obviated by ethyl nitrite. In a specific example, preservation of kidney blood flow with ethyl nitrite kept serum creatinine and blood urea nitrogen concentrations constant whereas in the CO2 alone group both increased as kidney blood flow declined. The data indicate ethyl nitrite can effectively attenuate insufflation-induced decreases in organ blood flow and nitric oxide bioactivity leading to reductions in markers of acute tissue injury. This simple intervention provides a method for controlling a major source of laparoscopic-related morbidity and mortality: tissue ischemia and altered postoperative organ function. |
| Databáze: | OpenAIRE |
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