HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jones, D. R. Articles by Murray, G. F. Search for Related Content PubMed PubMed Citation Articles by Jones, D. R. Articles by Murray, G. F.

The Annals of Thoracic Surgery, Vol 55, 1379-1382, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Effects of insufflation on hemodynamics during thoracoscopy

DR Jones, GM Graeber, GG Tanguilig, G Hobbs and GF Murray
Department of Surgery, West Virginia University School of Medicine, Morgantown 26506-9238.

Thoracic procedures once requiring open thoracotomy are now being performed with video-assisted thoracoscopy. To visualize adequately the intrathoracic structures, creation of an artificial pneumothorax by carbon dioxide insufflation under positive pressures has been advocated. We hypothesized that positive-pressure insufflation during thorascopy would cause significant hemodynamic compromise. Eight healthy female pigs underwent general endotracheal anesthesia and placement of monitoring lines. After placement of a thorascope, baseline hemodynamic measurements were obtained at 0 mm Hg (atmospheric pressure). Measurements were taken randomly at 5, 10, and 15 mm Hg using carbon dioxide insufflation after stabilization at each pressure. Data were analyzed using Page's test for noparametric variables. Insufflation pressures of 5 mm Hg or greater resulted in significant decreases in cardiac index, mean arterial pressure, stroke volume, and left ventricular stroke work index, whereas central venous pressure increased (p < 0.001). Changes in heart rate were not significant. We do not recommend routine positive-pressure insufflation during thorascopy because of the significant hemodynamic compromise in our experimental model.

This article has been cited by other articles:

				V. V. Bintintan, A. Mehrabi, H. Fonouni, M. Esmaeilzadeh, B. P. Muller-Stich, G. Funariu, C. Ciuce, and C. N. Gutt Feasibility of a High Intrathoracic Esophagogastric Anastomosis Without Thoracic Access After Laparoscopic-Assisted Transhiatal Esophagectomy: A Pilot Experimental Study Surgical Innovation, September 1, 2009; 16(3): 228 - 236. [Abstract] [PDF]

				A. M. Mukhtar, G. M. Obayah, A. Elmasry, and N. M. Dessouky The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients Anesth. Analg., January 1, 2008; 106(1): 84 - 88. [Abstract] [Full Text] [PDF]

				A. K. Saxena, C. Castellani, and M. E. Hollwarth Surgical aspects of thoracoscopy and efficacy of right thoracoscopy in minimally invasive repair of pectus excavatum J. Thorac. Cardiovasc. Surg., May 1, 2007; 133(5): 1201 - 1205. [Abstract] [Full Text] [PDF]

				C. M. Daly, K. Swalec-Tobias, A. H. Tobias, and N. Ehrhart Cardiopulmonary Effects of Intrathoracic Insufflation in Dogs J. Am. Anim. Hosp. Assoc., November 1, 2002; 38(6): 515 - 520. [Abstract] [Full Text] [PDF]

				C. Byhahn, S. Mierdl, D. Meininger, G. Wimmer-Greinecker, G. Matheis, and K. Westphal Hemodynamics and gas exchange during carbon dioxide insufflation for totally endoscopic coronary artery bypass grafting Ann. Thorac. Surg., May 1, 2001; 71(5): 1496 - 1501. [Abstract] [Full Text] [PDF]

				P. E. Stensrud Anesthesia for Thoracoscopy Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2000; 4(1): 18 - 25. [Abstract] [PDF]

				M. J. Krasna Introduction to Thoracoscopic Surgery: Indications, Basic Techniques, and Instrumentation Surgical Innovation, December 1, 1996; 3(4): 201 - 210. [Abstract] [PDF]

				W. S. Walker Video-Assisted Thoracic Surgery: Pulmonary Lobectomy Surgical Innovation, December 1, 1996; 3(4): 233 - 244. [Abstract] [PDF]

				R. C. Hill, D. R. Jones, R. A. Vance, and B. Kalantarian Selective Lung Ventilation During Thoracoscopy: Effects of Insufflation on Hemodynamics Ann. Thorac. Surg., March 1, 1996; 61(3): 945 - 948. [Abstract] [Full Text]

				D. E. Maziak and M. F. McKneally Video-Assisted Thoracic Surgery Ann. Thorac. Surg., March 1, 1995; 59(3): 780 - 781. [Full Text]

				S. Chan Anesthesia and Thoracoscopic Surgery Surgical Innovation, December 1, 1994; 1(4): 211 - 214. [Abstract] [PDF]

				C. H. Andrus, C. M. Wittgen, and K. S. Naunheim Anesthetic and Physiological Changes During Laparoscopy and Thoracoscopy: The Surgeon's View Surgical Innovation, December 1, 1994; 1(4): 228 - 240. [Abstract] [PDF]