| Autor: |
C M, Strang, U, Ebmeyer, E, Maripuu, T, Hachenberg, G, Hedenstierna |
| Rok vydání: |
2013 |
| Předmět: |
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| Zdroj: |
Minerva anestesiologica. 79(6) |
| ISSN: |
1827-1596 |
| Popis: |
Pneumoperitoneum (PP) by CO2-insufflation causes atelectasis however with maintained or even improved oxygenation. We studied the effect of abdominal insufflation by carbon dioxide (CO2) and air on gas exchange during PP.Twenty-seven anesthetized pigs were studied during PP with insufflations to 12 mmHg by either 1/CO2, 2/ air or 3/CO2 during intravenous nitroprusside infusion (SNP) (N.=9 in each group). In 3 pigs in each group, gamma camera technique (SPECT) was used to study ventilation and perfusion distributions, in another 6 pigs an inert-gas technique (MIGET) was used for assessing ventilation-perfusion matching (VA/Q). Measurements were made during anesthesia before and after 60 minutes of PP.CO2-PP caused a shift of blood flow away from dependent, non-ventilated (atelectatic) to ventilated regions. Air-PP caused smaller, and SNP-PP even less shift of lung blood flow. Shunt decreased during CO2-PP (6 ± 1% compared to baseline 9 ± 2%, P0.05), did not change during Air-PP (10 ± 2%) and increased during SNP-PP (16 ± 2%, P0.05). PaO2 increased from baseline 35 ± 2 to 41 ± 3 kPa during CO2-PP and decreased to 32 ± 3 kPa during Air-PP and to 27 ± 3 kPa during SNP-PP (P0.05 for all three comparisons). PaCO2 increased during CO2- and SNP-PP.CO2-PP enhanced the shift of blood flow towards better ventilated areas of the lung compared to Air-PP and SNP blunted the effects seen with CO2-PP. SNP may thus have blunted and CO2 potentiated vasoconstriction, by hypoxic pulmonary vasoconstriction or another mechanism. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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