Department of Pediatric Surgery, University Medical Center, Mainz, Germany.
Surg Endosc. 2013 May;27(5):1791-7. doi: 10.1007/s00464-012-2651-3. Epub 2012 Dec 13.
The aim of this study was to evaluate the risk of an air embolization with the volume of the insufflation tube during induction of laparoscopy. A further objective was to determine the LD₅₀ of air in young piglets.
End-tidal carbon dioxide pressure ([Formula: see text]), pulmonary arterial pressure (P pa), heart rate (f c), and mean arterial pressure (P a carot) were measured in 17 piglets divided into three groups: group 1 (n = 6), bolus application (CO₂ embolization, followed by air embolization, 2 mL/kg each), group 2 (n = 7), continuous air embolization (30 min, 0.2 mL/kg/min), and group 3 (n = 4), continuous CO₂ embolization (30 min, 0.4 mL/kg/min).
All animals survived CO₂ embolism. Air embolization as a bolus (2 mL/kg) or with an accumulated volume of 3.1 mL/kg led to death. Decreases in [Formula: see text] indicated air or massive CO₂ embolization only. There was a good correlation between [Formula: see text] and P pa in case of air embolization (r = -0.80, p < 0.0001). In contrast, no dependency was recognized during CO₂ embolism (r = -0.17, p = 0.2).
In order to minimize the lethal risk of gas embolization, the insufflation system has to be completely filled with CO₂ before connecting to the patient.
本研究旨在评估在腹腔镜诱导过程中，随着注气导管体积的增加，发生气栓的风险。进一步的目的是确定幼年仔猪的空气 LD₅₀。
17 头仔猪被分为三组：组 1（n = 6），推注应用（CO₂栓塞，继之以空气栓塞，每次 2 mL/kg）；组 2（n = 7），连续空气栓塞（30 min，0.2 mL/kg/min）；组 3（n = 4），连续 CO₂栓塞（30 min，0.4 mL/kg/min）。在这三组中，测量呼气末二氧化碳分压（[Formula: see text]）、肺动脉压（P pa）、心率（f c）和平均动脉压（P a carot）。
所有动物均存活 CO₂栓塞。推注（2 mL/kg）或累积量为 3.1 mL/kg 的空气栓塞导致死亡。[Formula: see text]的降低表明存在空气或大量 CO₂栓塞。在空气栓塞的情况下，[Formula: see text]与 P pa 之间存在良好的相关性（r = -0.80，p < 0.0001）。相比之下，在 CO₂栓塞期间未识别到依赖性（r = -0.17，p = 0.2）。
为了最大限度地降低气体栓塞的致死风险，在将注气系统与患者连接之前，必须完全用 CO₂充满。
