Effect of Small Bowel Perforation During Laparoscopy on End-Tidal Carbon Dioxide: Observation in a Small Animal Model

Avital, Shmuel; Inbar, Roye; Ben‐Abraham, Ron; Szomstein, Samuel; Rosenthal, Raúl J.; Sckornik, Yehuda; Weinbroum, Avi A.

doi:10.1016/j.jss.2007.02.016

Cited by 1 publication

(2 citation statements)

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“…Nevertheless, our results strongly suggest that there is an upper limit of pressure that should be applied in the abdominal cavity, possibly B12 mmHg. Both our group and others [46,47] demonstrated both ex vivo and in a porcine model that the peritoneal absorption rate of CO 2 increases in direct correlation with intraabdominal pressure, however, only to a maximum pressure level of 12-16 mmHg. This occurrence was explained by the pressure occlusion gradient in peritoneal capillaries, where high pneumoperitoneal pressure would cause capillaries to collapse, thereby preventing CO 2 peritoneal diffusion to the blood.…”

Section: Discussionmentioning

confidence: 55%

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Renal oxidative stress following CO2 pneumoperitoneum-like conditions

et al. 2008

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Background Physiologic renal changes associated with pneumoperitoneum (PNP) have been described and various underlying mechanisms have been suggested. We investigated the possibility that PNP-associated renal damage is pressure dependent, and that oxidative stress is thereby involved. Materials and methods Seventy Wistar rat kidneys (n = 10 per group) were isolated. They were perfused with oxygenated, warm, Krebs-Henseleit solution containing 5% albumin within an isolated environment and subjected to various CO 2 pressures (0 [control], 3,5,8,12,15, and 18 mmHg) for 60 min. Half of each group was additionally perfused for 30 min at 0 mmHg pressure.Results Renal flow decreased proportionately to the applied pressure as did urine output: both decreased (P \ 0.05) after 60 and 90 min when pressure C8 mmHg was applied. Oxygen extraction decreased (P \ 0.05) during PNP in all pressurized groups. Xanthine oxidase (XO) activity and reduced glutathione in the tissues increased (P \ 0.05) proportionately to pressures C8 mmHg. All parameters slightly reversed toward baseline values, upon the release of the intra-chamber pressure, except for the 18 mmHg group's values. Conclusions CO 2 -PNP pressure induces kidney injury, possibly reversible immediately after pressure is annulled. Pressure is associated with oxidative stress, which interferes with cellular metabolism and function, possibly via an ischemic-reperfusion-like mechanism.

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Section: Discussionmentioning

confidence: 55%

“…The incoming perfusate was continually equilibrated with 95% O 2 + 5% CO 2 to achieve pO 2 [ 300 mmHg and pCO 2 of 34-38 mmHg, and pH of 7.34-7. 46.…”

Section: Isolated Perfused Kidney Preparationmentioning

confidence: 99%