caa a22 4500 475790693 CHVBK 20180406123709.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s004230000172 doi (NATIONALLICENCE)springer-10.1007/s004230000172 Cardiopulmonary changes during laparoscopy and vessel injury: comparison of CO2 and helium in an animal model [Elektronische Daten] [Christoph A. Jacobi, Tido Junghans, Frank Peter, Dorothea Naundorf, Jürgen Ordemann, Joachim M. Müller] Abstract.: Background: Injury of venous vessels during elevated intraperitoneal pressure is thought to cause possible fatal gas embolism, and helium may be dangerous because of its low solubility. Methods: Twenty pigs underwent laparoscopy with either CO2 (n=10) or helium (n=10) with a pressure of 15mmHg and standardized laceration (1cm) of the vena cava inferior. After 30s, the vena cava was clamped, closed endoscopically by a running suture and unclamped again. During the procedure changes of cardiac output (CO), heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary artery wedge pressure (PAWP), end tidal CO2 pressure (PETCO2), and arterial blood gas analyses (pH, pO2 and pCO2) were investigated. Results: No animal died during the experimental course (mean blood loss during laceration: CO2, 157±50ml; helium, 173±83ml). MAP and CO values showed a decrease after laceration of the vena cava in both groups that had already been completely compensated for before suturing. PETCO2 increased significantly after CO2 insufflation (P<0.01), while helium showed no effect. Laceration of the vena cava caused no significant changes in PETCO2 values in either group. Significant acidosis and an increase of pCO2 were only found in the CO2 group. Conclusions: The incidence of gas embolism during laparoscopy and accidental vessel injury seems to be very low. With the exception of acidosis and an increase of PETCO2 in the CO2 group, there were no differences in cardiopulmonary function between insufflation of CO2 and helium. Springer-Verlag, 2000 Laparoscopy, Vessel injury, Gas embolism, Carbon dioxide, Helium nationallicence Jacobi Christoph A. Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Junghans Tido Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Peter Frank Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Naundorf Dorothea Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Ordemann Jürgen Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Müller Joachim M. Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut https://doi.org/10.1007/s004230000172 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000172 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jacobi Christoph A. Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut NATIONALLICENCE 700 1- Junghans Tido Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut NATIONALLICENCE 700 1- Peter Frank Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut NATIONALLICENCE 700 1- Naundorf Dorothea Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut NATIONALLICENCE 700 1- Ordemann Jürgen Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut NATIONALLICENCE 700 1- Müller Joachim M. Department of Surgery, Humboldt-University of Berlin, Schumannstraße 20/21, 10098 Berlin, Germany aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer