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Published on: May 31, 2011
Microsphere intestinal blood flow analysis during pneumoperitoneum using carbon dioxide and helium
D Goitein1, P Papasavas, W Yeaney
1Department of Surgery, The Western Pennsylvania Hospital, Temple University School of Medicine, Clinical Campus, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA.
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.
