Literature DB >> 12101327

Pathogenesis of CO(2) pneumoperitoneum-induced metabolic hypoxemia in a rabbit model.

Ospan A Mynbaev1, Carlos R Molinas, Leila V Adamyan, Bernard Vanacker, Philippe R Koninckx.   

Abstract

STUDY
OBJECTIVE: To investigate the effects of carbon dioxide (CO(2)) pneumoperitoneum-induced changes in blood gases, acid-base balance, and oxygen homeostasis in rabbits.
DESIGN: Prospective, randomized, controlled study (Canadian Task Force classification I).
SETTING: University training and teaching center.
SUBJECTS: Twenty-six adult female New Zealand white rabbits. INTERVENTION: Anesthesia and pneumoperitoneum.
MEASUREMENTS AND MAIN RESULTS: In anesthetized rabbits arterial blood gases, acid-base balance, oxygenation values, and lactate concentrations were assayed during 2 hours. Spontaneous breathing, superficial and optimal ventilation without pneumoperitoneum, and with pneumoperitoneum at low (6 mm Hg) and higher (10 mm Hg) insufflation pressures were compared. The CO(2) pneumoperitoneum profoundly affected blood gases, acid-base balance, and oxygen homeostasis. Carboxemia with increasing end-tidal CO(2) and partial pressure of CO(2) (p <0.001), acidosis with decreasing pH (p <0.001), and base deficiency with decreasing actual base excess (p <0.001), standard base excess and standard bicarbonate and acid excess with increasing hydrogen bicarbonate (p <0.05 and <0.01) were found. Desaturation (p <0.01) with decreasing oxyhemoglobin p <0.05) and hemoglobin oxygen affinity (p <0.01) were also found. Carboxemia with acidosis was more pronounced with higher (p <0.01) than with lower (p >0.05) intraperitoneal pressures, and also with spontaneous breathing (p <0.05) and superficial ventilation (p <0.001) than with optimal ventilation, resulting in metabolic hypoxemia.
CONCLUSION: In superficially ventilated and spontaneously breathing rabbits, CO(2) pneumoperitoneum profoundly affected blood gases, acid-base balance, and oxygen homeostasis, resulting in metabolic hypoxemia. With optimal ventilation and low intraperitoneal pressure carboxemia, respiratory acidosis, and changes in oxygen metabolism were minimal.

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Year:  2002        PMID: 12101327     DOI: 10.1016/s1074-3804(05)60409-4

Source DB:  PubMed          Journal:  J Am Assoc Gynecol Laparosc        ISSN: 1074-3804


  7 in total

1.  A possible mechanism of peritoneal pH changes during carbon dioxide pneumoperitoneum.

Authors:  O A Mynbaev; P R Koninckx; L Dolle'; M Bracke
Journal:  Surg Endosc       Date:  2006-11-14       Impact factor: 4.584

2.  Severe inflammatory reaction induced by peritoneal trauma is the key driving mechanism of postoperative adhesion formation.

Authors:  Sergei V Pismensky; Zhomart R Kalzhanov; Marina Yu Eliseeva; Ioannis P Kosmas; Ospan A Mynbaev
Journal:  BMC Surg       Date:  2011-11-14       Impact factor: 2.102

3.  Comment on "Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress".

Authors:  Almas K Ormantayev; Anar D Sepbayeva; Ioannis P Kosmas; Amirkhan K Baimaganbetov; Viktor Y Issakov; Ospan A Mynbaev
Journal:  ScientificWorldJournal       Date:  2015-06-11

4.  A surgical polypragmasy: Koninckx PR, Corona R, Timmerman D, Verguts J, Adamyan L. Peritoneal full-conditioning reduces postoperative adhesions and pain: a randomised controlled trial in deep endometriosis surgery. J Ovarian Res. 2013 Dec 11;6(1):90.

Authors:  Ospan A Mynbaev; Peter Biro; Marina Yu Eliseeva; Andrea Tinelli; Antonio Malvasi; Ioannis P Kosmas; Mykhailo V Medvediev; Tatiana I Babenko; Madina I Mazitova; Sergei S Simakov; Michael Stark
Journal:  J Ovarian Res       Date:  2014-03-10       Impact factor: 4.234

5.  Peritoneal full-conditioning reduces postoperative adhesions and pain: a randomised controlled trial in deep endometriosis surgery.

Authors:  Philippe R Koninckx; Roberta Corona; Dirk Timmerman; Jasper Verguts; Leila Adamyan
Journal:  J Ovarian Res       Date:  2013-12-11       Impact factor: 4.234

Review 6.  Adhesion formation after laparoscopic surgery: what do we know about the role of the peritoneal environment?

Authors:  C R Molinas; M M Binda; G D Manavella; P R Koninckx
Journal:  Facts Views Vis Obgyn       Date:  2010

Review 7.  Humidification during laparoscopic surgery: overview of the clinical benefits of using humidified gas during laparoscopic surgery.

Authors:  Maria Mercedes Binda
Journal:  Arch Gynecol Obstet       Date:  2015-04-25       Impact factor: 2.344

  7 in total

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