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A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow.

Publication ,  Journal Article
Ali, NA; Eubanks, WS; Stamler, JS; Gow, AJ; Lagoo-Deenadayalan, SA; Villegas, L; El-Moalem, HE; Reynolds, JD
Published in: Ann Surg
February 2005

OBJECTIVE: To determine if increasing nitric oxide bioactivity by inclusion of ethyl nitrite (ENO) in the insufflation admixture would attenuate pneumoperitoneum-induced decreases in splanchnic perfusion. SUMMARY BACKGROUND DATA: Organ blood flow is reduced during pneumoperitoneum and can contribute to laparoscopy-associated morbidity and mortality. Previous attempts to control such decreases in flow have been ineffective. METHODS: Laser-Doppler flow probes were placed on the liver and right kidney of anesthetized pigs. After a baseline recording period, animals were insufflated to a final intraperitoneal pressure of 15 mm Hg. Group one received CO2 (standard practice), whereas group 2 received CO2 plus 100 ppm ENO. Insufflation was maintained for 60 minutes and then the abdomen was manually deflated; monitoring was continued for another 60 minutes. RESULTS: CO2 insufflation (n = 5) cut liver blood flow in half; liver flow remained at this level throughout the postinsufflation period. Inclusion of 100 ppm ENO (n = 6) attenuated both the acute and prolonged blood flow decreases. Statistical modeling of the data showed that, on average, liver blood flow was 14.3 U/min higher in the ENO pigs compared with the CO2 group (P = 0.0454). In contrast, neither treatment significantly altered kidney blood flow (P = 0.6215). CONCLUSION: The data indicate that ENO can effectively attenuate pneumoperitoneum-induced blood flow decreases within the peritoneal cavity. The result suggests a novel therapeutic method of regulating hemodynamic changes during laparoscopic procedures.

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Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

February 2005

Volume

241

Issue

2

Start / End Page

256 / 261

Location

United States

Related Subject Headings

  • Swine
  • Surgery
  • Splanchnic Circulation
  • Regional Blood Flow
  • Pneumoperitoneum, Artificial
  • Nitrites
  • Liver
  • Kidney
  • Dose-Response Relationship, Drug
  • Animals
 

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Ali, N. A., Eubanks, W. S., Stamler, J. S., Gow, A. J., Lagoo-Deenadayalan, S. A., Villegas, L., … Reynolds, J. D. (2005). A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow. Ann Surg, 241(2), 256–261. https://doi.org/10.1097/01.sla.0000153034.54128.5e
Ali, Nishath Athar, W Steve Eubanks, Jonathan S. Stamler, Andrew J. Gow, Sandhya A. Lagoo-Deenadayalan, Leonardo Villegas, Habib E. El-Moalem, and James D. Reynolds. “A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow.Ann Surg 241, no. 2 (February 2005): 256–61. https://doi.org/10.1097/01.sla.0000153034.54128.5e.
Ali NA, Eubanks WS, Stamler JS, Gow AJ, Lagoo-Deenadayalan SA, Villegas L, et al. A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow. Ann Surg. 2005 Feb;241(2):256–61.
Ali, Nishath Athar, et al. “A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow.Ann Surg, vol. 241, no. 2, Feb. 2005, pp. 256–61. Pubmed, doi:10.1097/01.sla.0000153034.54128.5e.
Ali NA, Eubanks WS, Stamler JS, Gow AJ, Lagoo-Deenadayalan SA, Villegas L, El-Moalem HE, Reynolds JD. A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow. Ann Surg. 2005 Feb;241(2):256–261.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

February 2005

Volume

241

Issue

2

Start / End Page

256 / 261

Location

United States

Related Subject Headings

  • Swine
  • Surgery
  • Splanchnic Circulation
  • Regional Blood Flow
  • Pneumoperitoneum, Artificial
  • Nitrites
  • Liver
  • Kidney
  • Dose-Response Relationship, Drug
  • Animals