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The detection of carbon dioxide embolism during laparoscopy in pigs: a comparison of transesophageal Doppler and end‐tidal carbon dioxide monitoring
Author(s) -
MANN C.,
BOCCARA G.,
FABRE J. M.,
GREW V.,
COLSON P.
Publication year - 1997
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1997.tb04680.x
Subject(s) - medicine , pneumoperitoneum , anesthesia , embolism , laparoscopic cholecystectomy , air embolism , carbon dioxide , doppler effect , catheter , femoral vein , laparoscopy , surgery , complication , ecology , physics , astronomy , biology
Background: The aim of the study was to compare the value of transesophageal Doppler and end‐tidal carbon dioxide monitoring to detect venous carbon dioxide embolism in pigs during laparoscopic cholecystectomy. Method: Ten pigs were anesthetized under constant ventilation, and instrumented for laparoscopic cholecystectomy. CO 2 pneumoperitoneum was performed at 15 mmHg and then, successive increased intravenous gas boluses of 0.1 to 4 ml/ kg injectedthrough the femoral vein using a 55‐mm long catheter. The responses indicative of embolism were defined as: 1) a change in Doppler tone placed facing the junction of the right atrium and inferior vena cava; 2) Results: Doppler was more sensitive in detecting 0.1, 0.2 and 0.4 ml/mg of CO 2 embolism than end‐tidal CO 2 ( P <0.05). Over 0.4 ml/mg no differences in sensitivity were found but the Doppler signal modifications occurred earlier than the changes in end‐tidal CO 2 . Moreover, these changes always consisted of a reduction of the value. Conclusions: During laparoscopic cholecystectomy in pigs, transesophageal Doppler was a highly sensitive monitor which provided an earlier detection of CO 2 embolism and at lower doses than end‐tidal CO 2 monitoring.