Effects of adding small amounts of oxygen to a carbon dioxide–pneumoperitoneum of increasing pressure in rabbit ventilation models

Mynbaev, Ospan A.; Adamyan, L.V.; Mailova, Karina; Vanacker, Bernard; Koninckx, Philippe

doi:10.1016/j.fertnstert.2008.07.019

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…24,25 Moreover, it can be a co-factor in the formation of postoperative adhesions; the longer the duration of pneumoperitoneum, the greater the incidence rate for adhesions. 26 The present explorative analyses also found no significant difference with respect to sex and preoperative nursing issues, indicating that the occurrence and deterioration of specific risk factors and nursing issues occurred equally in both men and women. However, considering other risks such as the dangers of aspiration and imbalance of body fluid, hypothermia, hypoxia, tissue hypoperfusion, all of these have a close correlation with age.…”

Section: Discussioncontrasting

confidence: 40%

Implementation of Standardized Perioperative Care for Laparoscopic Roux-en-Y Gastric Bypass in a New Program at a Chinese Hospital

XuDuo

LinWei-Hong

Xumin

et al. 2015

Bariatric Surgical Practice and Patient Care

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Objectives: The aims of this study were to analyze the specific risk factors during the treatment of metabolic diseases when using laparoscopic Roux-en-Y gastric bypass (LRYGB), and to explore and identify a system for intraoperative nursing problems and the effects of corresponding nursing interventions. Methods: A systems for intraoperative nursing problems was established by taking 44 patients who underwent LRYGB from May 2010 to November 2012 at the First Affiliated Hospital of Wenzhou Medical University. The constituent ratio of the specific risk factors and nursing problems and the effects of the corresponding nursing interventions for specific risk factors were analyzed. Results: The specific intraoperative nursing problems of LRYGB found include risk for aspiration and deficient fluid volume, hypothermia, suffocation, tissue hypoperfusion, and diabetic ketoacidosis (DKA), which correlated with age ( p < 0.05). After appropriate nursing interventions, risks for suffocation, aspiration, DKA, and hypothermia were significantly reduced ( p < 0.05). Conclusions: Identifying nursing problems during LRYGB may provide guidance for the intraoperative nursing team. Understanding the corresponding nursing interventions can reduce the incidence rate of potential risks, and hence improve the safety of the procedure.

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Section: Discussioncontrasting

confidence: 40%

Implementation of Standardized Perioperative Care for Laparoscopic Roux-en-Y Gastric Bypass in a New Program at a Chinese Hospital

XuDuo

LinWei-Hong

Xumin

et al. 2015

Bariatric Surgical Practice and Patient Care

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“…From this, a large body of literature has sprung studying the pathophysiologic mechanisms of CO 2 -pneumoperitoneum induced systemic alterations such as respiratory, cardiovascular and blood gas, acid base parameters changes, as well as local disturbances in the peritoneal cavity such as decreased peritoneal pH and blood circulatory deteriorations with mesothelial hypoxemia during laparoscopic surgery [24-29]. The discussion has polarised: some claim these changes have a crucial impact on postsurgical complications such as adhesion formation and port-site cancer metastasis [30-34] others say these changes have no or little impact on postsurgical complications [16,17,28,29].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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BackgroundMany factors have been put forward as a driving mechanism of surgery-triggered adhesion formation (AF). In this study, we underline the key role of specific surgical trauma related with open surgery (OS) and laparoscopic (LS) conditions in postoperative AF and we aimed to study peritoneal tissue inflammatory reaction (TIR), remodelling specific complications of open surgery (OS) versus LS and subsequently evaluating AF induced by these conditions.MethodsA prospective randomized study was done in 80 anaesthetised female Wistar rats divided equally into 2 groups. Specific traumatic OS conditions were induced by midline incision line (MIL) extension and tissue drying and specific LS conditions were remodelled by intraperitoneal CO2 insufflation at the 10 cm of water. TIR was evaluated at the 24th, 72nd, 120th and 168th hour by scoring scale. Statistical analysis was performed by the non-parametric t test and two-way ANOVA using Bonferroni post-tests.ResultsMore pronounced residual TIR was registered after OS than after LS. There were no significant TIR interactions though highly significant differences were observed between the OS and LS groups (p < 0.0001) with regard to surgical and time factors. The TIR change differences between the OS and LS groups were pronounced with postoperative time p < 0.05 at the 24th and 72nd; p < 0.01 - 120th and p < 0.001 - 168th hrs. Adhesion free wounds were observed in 20.0 and 31.0% of cases after creation of OS and LS conditions respectively; with no significant differences between these values (p > 0.05). However larger adhesion size (41.67 ± 33.63) was observed after OS in comparison with LS (20.31 ± 16.38). The upper-lower 95% confidential limits ranged from 60.29 to 23.04 and from 29.04 to 11.59 respectively after OS and LS groups with significant differences (p = 0.03). Analogous changes were observed in adhesion severity values. Subsequently, severe TIR parameters were followed by larger sizes of severe postoperative adhesions in the OS group than those observed in the LS group.ConclusionsMIL extension and tissue drying seem to be the key factors in the pathogenesis of adhesion formation, triggering severe inflammatory reactions of the peritoneal tissue surrounding the MIL resulting in local and systemic consequences. CO2 insufflation however, led to moderate inflammation and less adhesion formation.

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“…The authors clearly demonstrated significant changes of the peak in respiratory pressure, dynamic lung compliance, P ET CO 2 , arterial pO 2 , pCO 2 , and pH values at the 30th min of CO 2 -pneumoperitoneum in comparison with parameters of both at the baseline and at the end of surgery. These changes we considered as consequences of a causative force of CO 2 -insufflation with increased content of CO 2 in the body (rise of P ET CO 2 and arterial pCO 2 ), with subsequent mild respiratory or severe acidosis (reduced pH) depending on intraperitoneal pressure rate and CO 2 -pneumoperitoneum duration [ 4 – 6 ]. Subsequently, the dynamic lung compliance was reduced with increased peak of respiratory pressure in adult patients with ASA I/II [ 1 ].…”

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confidence: 99%

Comment on “Evidence for Negative Effects of Elevated Intra‐Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

Ormantayev

Sepbayeva

Kosmas

et al. 2015

The Scientific World Journal

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Effects of adding small amounts of oxygen to a carbon dioxide–pneumoperitoneum of increasing pressure in rabbit ventilation models

Cited by 5 publications

References 33 publications

Implementation of Standardized Perioperative Care for Laparoscopic Roux-en-Y Gastric Bypass in a New Program at a Chinese Hospital

Implementation of Standardized Perioperative Care for Laparoscopic Roux-en-Y Gastric Bypass in a New Program at a Chinese Hospital

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

Comment on “Evidence for Negative Effects of Elevated Intra‐Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

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