Fisher and Paykel Healthcare, Auckland, New Zealand.
School of Biological Sciences, University of Auckland, Auckland, New Zealand.
PLoS One. 2018 Apr 4;13(4):e0195465. doi: 10.1371/journal.pone.0195465. eCollection 2018.
Tissue perfusion during surgery is important in reducing surgical site infections and promoting healing. This study aimed to determine if insufflation of the open abdomen with heated, humidified (HH) carbon dioxide (CO2) increased visceral tissue perfusion and core body temperature during open abdominal surgery in a rodent model. Using two different rodent models of open abdominal surgery, visceral perfusion and core temperature were measured. Visceral perfusion was investigated using a repeated measures crossover experiment with rodents receiving the same sequence of two alternating treatments: exposure to ambient air (no insufflation) and insufflation with HH CO2. Core body temperature was measured using an independent experimental design with three treatment groups: ambient air, HH CO2 and cold, dry (CD) CO2. Visceral perfusion was measured by laser speckle contrast analysis (LASCA) and core body temperature was measured with a rectal thermometer. Insufflation with HH CO2 into a rodent open abdominal cavity significantly increased visceral tissue perfusion (2.4 perfusion units (PU)/min (95% CI 1.23-3.58); p<0.0001) compared with ambient air, which significantly reduced visceral blood flow (-5.20 PU/min (95% CI -6.83- -3.58); p<0.0001). Insufflation of HH CO2 into the open abdominal cavity significantly increased core body temperature (+1.15 ± 0.14°C) compared with open cavities exposed to ambient air (-0.65 ± 0.52°C; p = 0.037), or cavities insufflated with CD CO2 (-0.73 ± 0.33°C; p = 0.006). Abdominal visceral temperatures also increased with HH CO2 insufflation compared with ambient air or CD CO2, as shown by infrared thermography. This study reports for the first time the use of LASCA to measure visceral perfusion in open abdominal surgery and shows that insufflation of open abdominal cavities with HH CO2 significantly increases visceral tissue perfusion and core body temperature.
手术过程中的组织灌注对于减少手术部位感染和促进愈合很重要。本研究旨在确定在开放性腹部手术中，向开放性腹部吹入加热加湿（HH）的二氧化碳（CO2）是否会增加内脏组织灌注和核心体温。使用两种不同的开放性腹部手术啮齿动物模型，测量内脏灌注和核心体温。使用重复测量交叉实验研究内脏灌注，啮齿动物接受两种交替处理的相同顺序：暴露于环境空气中（无吹入）和用 HH CO2 吹入。核心体温使用独立实验设计，有三个处理组：环境空气、HH CO2 和冷干（CD）CO2。通过激光散斑对比分析（LASCA）测量内脏灌注，通过直肠温度计测量核心体温。与环境空气相比，向啮齿动物开放性腹腔内吹入 HH CO2 可显著增加内脏组织灌注（2.4 灌注单位（PU）/分钟（95%CI 1.23-3.58）；p<0.0001），而环境空气则显著减少内脏血流（-5.20 PU/min（95%CI-6.83- -3.58）；p<0.0001）。与暴露于环境空气中的开放性腹腔（-0.65 ± 0.52°C；p = 0.037）或用 CD CO2 吹入的开放性腹腔（-0.73 ± 0.33°C；p = 0.006）相比，向开放性腹腔内吹入 HH CO2 可显著增加核心体温（+1.15 ± 0.14°C）。与环境空气或 CD CO2 相比，HH CO2 吹入也会增加腹部内脏温度，如红外热成像所示。本研究首次报告使用 LASCA 测量开放性腹部手术中的内脏灌注，并表明向开放性腹部吹入 HH CO2 可显著增加内脏组织灌注和核心体温。
