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

Nishath Athar Ali, W. Steve Eubanks, Jonathan S. Stamler, Andrew J. Gow, Sandhya A. Lagoo-Deenadayalan, Leonardo Villegas, Habib E. El-Moalem, James D. Reynolds

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)256-261
Number of pages6
JournalAnnals of Surgery
Volume241
Issue number2
DOIs
Publication statusPublished - Feb 2005
Externally publishedYes

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Pneumoperitoneum
Viscera
Insufflation
Liver
Swine
Kidney
Peritoneal Cavity
Abdomen
Laparoscopy
Nitric Oxide
Lasers
Perfusion
Hemodynamics
Morbidity
Pressure
Mortality
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

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. Annals of Surgery, 241(2), 256-261. https://doi.org/10.1097/01.sla.0000153034.54128.5e

A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow. / Ali, Nishath Athar; Eubanks, W. Steve; Stamler, Jonathan S.; Gow, Andrew J.; Lagoo-Deenadayalan, Sandhya A.; Villegas, Leonardo; El-Moalem, Habib E.; Reynolds, James D.

In: Annals of Surgery, Vol. 241, No. 2, 02.2005, p. 256-261.

Research output: Contribution to journalArticle

Ali, NA, Eubanks, WS, Stamler, JS, Gow, AJ, Lagoo-Deenadayalan, SA, Villegas, L, El-Moalem, HE & Reynolds, JD 2005, 'A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow', Annals of Surgery, vol. 241, no. 2, pp. 256-261. 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. Annals of Surgery. 2005 Feb;241(2):256-261. https://doi.org/10.1097/01.sla.0000153034.54128.5e
Ali, Nishath Athar ; Eubanks, W. Steve ; Stamler, Jonathan S. ; Gow, Andrew J. ; Lagoo-Deenadayalan, Sandhya A. ; Villegas, Leonardo ; El-Moalem, Habib E. ; Reynolds, James D. / A method to attenuate pneumoperitoneum-induced reductions in splanchnic blood flow. In: Annals of Surgery. 2005 ; Vol. 241, No. 2. pp. 256-261.
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