The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors

Abstract

The aim of this experimantal study which is applied on rats, is to determine the differences on the clotting factors over the application of low and high intraabdominal pressure (IAP) values in different periods of time in carbon dioxide (CO 2 ) pneumoperitoneum. Thirty rats were randomized into five groups (n = 6): a control group (Group K) and 1 h and 6 mm Hg IAP (Group A), 2 h and 6 mm Hg IAP (Group B), 1 h and 12 mm Hg IAP (Group C) and 2 h and 12 mm Hg IAP were created with CO 2 pneumoperitoneum (Group D). At the end of the experiment, plasma samples taken from subjects and fibrinogen, FII (prothrombin), FV, FVII, FVIII, FIX, FX, FXI, FXII, von willebrand's factor (vWF), ristocetin cofactor, protein C, protein S, antithrombin III (AT III) levels are studied. There were statistically significant differences in the mean levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII, and protein S between the groups. A hypercoagulable state occurred with the following: increase in the coagulation parameters compared to the control group; increase in FVII in the group only Group C; decrease in AT III in all groups compared to the control group; decrease in protein C in the group only XII Group D compared to control group; decrease in protein S in all groups except group D compared to control group. CO 2 insufflation predisposes to thromboembolic events both by inducing coagulation factors and by suppressing the fibrinolytic system contrary to the controversies in the literature.

Changing Times for the IJHBT

“…Among the benign disorders, Dubey et al [6] investigate how life-saving intra-uterine blood transfusions to Rh-negative fetuses of Rh-positive mothers may carry the risk of inducing additional maternal antibodies against fetal antigens, thereby aggravating Rhisoimmunization. Sen et al [7] similarly caution that highpressure carbon dioxide insufflation, commonly used in laparoscopic surgeries, may depress natural anticoagulant systems as well as fibrinolysis thus contributing to surgeryassociated thrombophilia.…”

Hemocoagulative Modifications after Laparoscopic Surgery at Different Pneumoperitoneum Pressure Settings

“…Sen et al carried out a randomized study on rats divided into 4 different groups, respectively group A exposed to 6 mmHg of pressure for 1 hour, group B exposed to 6 mmHg of pressure for 2 h, group C exposed to 12 mmHg of pressure for 1 hour, group D exposed to 12 mmHg of pressure for 2 h. The study showed evidence of hyperactivation of coagulation in the groups subjected to high pressure and for a longer time, demonstrated by an increase in its factors and in fibrinogen, and a reduced activity of the fibrinolytic system [ 13 ].…”

CajaDB: A DATABASE OF COMMON MARMOSETS (Callithrix jacchus)

“…The same occurs in the lung submitted to a regime of non-physiological pressure levels, which further accentuates the change in homeostasis. Inflammatory factors caused by the surgery trauma, PNP pressure, and mechanical ventilation promote the formation of these ROS, time-exposure dependent [39][40][41][42][43].…”

“…Os genogrupos I, II e IV compreendem os genótipos encontrado em seres humanos. As infecções pelo GI e GII são responsáveis pela maioria das doenças em humanos, enquanto as infecções associadas pelo genótipo GII.4 ocorrem com maior frequência e apresentam-se como uma das maiores causas das gastroenterites epidêmicas ou esporádicas (28,53,43,61,97) . O genogrupo GIII inclui vírus identificados em bovinos (73) , enquanto aqueles identificados em suínos estão classificados no genogrupo GII (90,99) .…”