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Effects of insufflation on hemodynamics during thoracoscopy
D R Jones1, G M Graeber, G G Tanguilig
1Department of Surgery, West Virginia University School of Medicine, Morgantown 26506-9238.
The Annals of Thoracic Surgery
|June 1, 1993
Summary
Positive-pressure carbon dioxide insufflation during video-assisted thoracoscopy can cause significant hemodynamic compromise. This method is not recommended due to decreased cardiac index and blood pressure in animal models.
Area of Science:
- Cardiovascular Physiology
- Thoracic Surgery
Background:
- Video-assisted thoracoscopy (VATS) is increasingly used for thoracic procedures, often requiring artificial pneumothorax.
- Carbon dioxide insufflation is a common method to create this pneumothorax during VATS.
Purpose of the Study:
- To investigate the hemodynamic effects of positive-pressure carbon dioxide insufflation during thoracoscopy.
- To determine if insufflation pressures cause significant cardiovascular compromise.
Main Methods:
- Eight healthy female pigs were used as an experimental model.
- Hemodynamic parameters were measured at baseline (0 mm Hg) and during CO2 insufflation at 5, 10, and 15 mm Hg.
- Data were analyzed using non-parametric statistical tests.
Main Results:
- CO2 insufflation at 5 mm Hg or greater significantly decreased cardiac index, mean arterial pressure, stroke volume, and left ventricular stroke work index.
- Central venous pressure significantly increased with insufflation.
- Heart rate changes were not statistically significant.
Conclusions:
- Positive-pressure carbon dioxide insufflation during thoracoscopy leads to significant hemodynamic compromise.
- Routine use of this technique is not recommended due to adverse cardiovascular effects observed in the experimental model.