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Gas embolism: helium is more lethal than carbon dioxide
J S Wolf1, S Carrier, M L Stoller
1Department of Urology, University of California School of Medicine, San Francisco.
Journal of Laparoendoscopic Surgery
|June 1, 1994
Summary
Helium insufflation during laparoscopy may pose risks. Intravenous helium injections were fatal in dogs, unlike carbon dioxide (CO2), indicating higher lethality and potential patient danger from venous gas embolism.
Area of Science:
- Medical research
- Surgical innovation
- Anesthesiology
Background:
- Carbon dioxide (CO2) is the standard insufflating gas for laparoscopy.
- Helium is explored as a CO2 alternative due to its non-combustible nature and lack of pharmacologic effects.
- Helium's low blood solubility raises concerns about exacerbating venous gas embolism.
Purpose of the Study:
- To compare the lethality of intravenous carbon dioxide (CO2) and helium injections.
- To assess the safety of helium as a potential insufflating agent in laparoscopic surgery.
Main Methods:
- Rapid intravenous injections of CO2 and helium were administered to 4 dogs.
- Gas volumes ranged from 5 to 10 ml/kg body weight.
- Outcomes and recovery times were meticulously recorded.
Main Results:
- Recovery from CO2 injection consistently occurred within 1 minute.
- Helium injections resulted in fatality in 4 out of 6 instances.
- Helium demonstrated significantly higher lethality compared to CO2 in this canine model.
Conclusions:
- Helium is demonstrably more lethal than CO2 when administered intravenously.
- The use of helium for laparoscopic insufflation may increase patient risk for adverse events, particularly venous gas embolism.
- Further research is warranted to evaluate the safety profile of helium in clinical settings.