Microsphere intestinal blood flow analysis during pneumoperitoneum using carbon dioxide and helium.
BACKGROUND
Pneumoperitoneum has been associated with a decreased flow in the superior mesenteric artery and portal venous system. Intestinal blood flow was studied during a 2-h pneumoperitoneum with carbon dioxide (CO2) or helium in a porcine model using colored microspheres.


METHODS
For this study, 12 pigs were divided into two groups (6 CO2 and 6 helium). Different colored microspheres were injected directly into the left ventricle before, 40, 80, and 120 min after insufflation with either gas at a pressure of 15 mmHg. Microsphere concentration was measured in the mucosa and muscularis/serosa layers of the jejunum, cecum, and sigmoid colon to calculate blood flow.


RESULTS
Intestinal perfusion initially increases with insufflation and returns to near baseline levels during pneumoperitoneum of 2 h. The effect of helium on tissue perfusion is similar to that of carbon dioxide.


CONCLUSIONS
Intestinal perfusion does not change significantly during prolonged pneumoperitoneum at a pressure of 15 mmHg with CO2 or helium.
Goitein
D
D
Department of Surgery, The Western Pennsylvania Hospital, Temple University School of Medicine, Clinical Campus, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA.
Papasavas
P
P
Yeaney
W
W
Gagne
D
D
Hayetian
F
F
Caushaj
P
P
Keenan
R
R
Landreneau
R
R
D000818:Animals; D001783:Blood Flow Velocity; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000494:pharmacology*; D002302:Cardiac Output; D002432:Cecum / Q000098:blood supply; D012809:Colon, Sigmoid / Q000098:blood supply; D006339:Heart Rate; D006371:Helium / Q000008:administration & dosage / Q000494:pharmacology*; D007327:Insufflation; D007413:Intestinal Mucosa / Q000098:blood supply; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology; D007583:Jejunum / Q000098:blood supply; D008863:Microspheres; D009130:Muscle, Smooth / Q000098:blood supply; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods; D011312:Pressure; D034421:Sus scrofa
D002245:Carbon Dioxide; D006371:Helium
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