title: Tracheal gas isufflation-aided mechanical ventilation during carbon dioxide-induced pneumoperitoneum in rabbits.
abstract: Despite numerous benefits of laparoscopic procedures, the serious hypercapnia and respiratory acidosis in hypercapnic patients with decreased pulmonary compliance during carbon dioxide-induced pneumoperitoneum (CDP) may be developed. Tracheal gas insufflation (TGI) has been shown to be a useful adjunct to controlled mechanical hypoventilation. This study was undertaken to identify whether TGI superimposed on controlled mechanical ventilation (CMV) improve ventilatory efficiency during CDP in rabbits. Sixteen paralyzed and anesthetized rabbits were used. The animals were assigned to two groups-CMV group: CMV alone; TGI group: CMV superimposed by TGI with flow rate of 2L/min. The animals were insufflated to intra-abdominal pressure of 8 mmHg with CO2 gas. Then, tidal volume (V(T)) was changed to maintain the set peak inspiratory pressure (PIP) value, while other ventilatory settings were kept constant. The set PIP value corresponding to 30, 60, and 90 min after the start of peritoneal insufflation of CO2 were 15, 22, and 25 cm H2O, respectively. During CDP with TGI, PaCO2 decreased significantly (p<0.01) from CMV without TGI of 82.1 +/- 14.1 to 47.5 +/- 5.5, 58.1 +/- 9.9 to 40.0 +/- 4.6, 47.1 +/- 9.4 to 32.7 +/- 5.1 mmHg at PIP of 15, 22, and 25 cm H2O, respectively. The inspired V(T) decreased significantly (p<0.05) from CMV without TGI of 18.4 +/- 3.9 to 12.8 +/- 2.8 ml at PIP of 15 cm H2O. TGI superimposed on CMV is more effective than CMV alone in enhancing ventilatory efficiency during CDP in rabbits.
authors.affiliation: Department of Laboratory Animal Research, Samsung Biomedical Research Institute, Seoul, Korea.
authors.forename: Jong-Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Byeong-Han
authors.initials: BH
authors.lastname: Lee
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Jang
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Jeon
authors.forename: Hwi-Yool
authors.initials: HY
authors.lastname: Kim
authors.forename: Jin-Soo
authors.initials: JS
authors.lastname: Han
authors.forename: Youn-Leol
authors.initials: YL
authors.lastname: Lee
authors.forename: Min-Jae
authors.initials: MJ
authors.lastname: Lee
mesh_terms: D000818:Animals; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood / Q000633:toxicity*; D004867:Equipment Design; D006339:Heart Rate; D010313:Partial Pressure; D011027:Pneumoperitoneum / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy / Q000662:veterinary*; D011817:Rabbits; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods* / Q000662:veterinary*
chemical_list: D002245:Carbon Dioxide