Reduction of CO2-pneumoperitoneum-induced metabolic hypoxaemia by the addition of small amounts of O2 to the CO2 in a rabbit ventilated model. A preliminary study
| Autor: | Carlos Roger Molinas, Ospan A. Mynbaev, Philippe R. Koninckx, Bernard Vanacker, Leila Adamyan |
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| Rok vydání: | 2002 |
| Předmět: |
Acid–base homeostasis
pCO2 Hypoxemia Pneumoperitoneum medicine Animals Humans Hypoxia Acidosis business.industry Rehabilitation Metabolic disorder Obstetrics and Gynecology Endoscopy Carbon Dioxide medicine.disease Respiration Artificial Oxygen Reproductive Medicine Anesthesia Models Animal Breathing Arterial blood Female Rabbits medicine.symptom business Pneumoperitoneum Artificial |
| Zdroj: | Human Reproduction. 17:1623-1629 |
| ISSN: | 1460-2350 0268-1161 |
| Popis: | BACKGROUND: CO2-pneumoperitoneum used in endoscopic surgery induces system effects by CO2 absorption. This study investigated the effect of the addition of O2 to CO2-pneumoperitoneum, upon CO2 absorption. METHODS: The effect of a pneumoperitoneum using 100% CO2 or 94% CO2 6% O2 upon arterial blood gases, acid base and O2 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: CO2pneumoperitoneum profoundly affected blood gases and acid base homeostasis i.e. increasing pCO2, HCO3 (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 pO2 (P < 0.001) and O2Hb (P < 0.05). These effects were more pronounced with higher PP and suboptimal ventilation. CONCLUSION: CO2pneumoperitoneum profoundly affected blood gases and acid base homeostasis resulting in metabolic hypoxaemia. The addition of 6% of O2 to the CO2-pneumoperitoneum prevented these effects to a large extent. If these preliminary data are confirmed in the human, the addition of a few percent of O2 to CO2 could become important for endoscopic surgery of long duration, especially in obese patients with limited cardiorespiratory adaptation and steep Trendelenburg. |
| Databáze: | OpenAIRE |
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