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

This Article Full Text Full Text (PDF) 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 Author home page(s): Toshiya Ohtsuka Tadasu Kohno Jun Nakajima Yutaka Kotsuka Shinichi Takamoto Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ohtsuka, T. Articles by Takamoto, S. Search for Related Content PubMed PubMed Citation Articles by Ohtsuka, T. Articles by Takamoto, S.

Ann Thorac Surg 1999;68:29-32
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Hemodynamic effects of carbon dioxide insufflation under single-lung ventilation during thoracoscopy

^a Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan

Address reprint requests to Dr Ohtsuka, Department of Cardiothoracic Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 Japan
e-mail: ohtsuka-tho{at}h.u-tokyo.ac.jp

Background. The hemodynamic effects of carbon dioxide insufflation under single-lung ventilation were studied in 22 consecutive thoracoscopic harvests of the left internal mammary artery, which was used for minimally invasive coronary artery bypass grafting.

Methods. An electrocardiograph, arterial catheter, Swan-Ganz catheter, and transesophageal echocardiograph were used to monitor seven hemodynamic variables. Baseline data were obtained during ventilation of both lungs and the measurements were repeated after the left lung was collapsed and at 5 and 30 minutes after hemithorax insufflation with low-flow (2 to 3 L/minute) carbon dioxide gas was begun. The intrapleural pressure was maintained at 8 to 10 mm Hg.

Results. Thoracoscopic harvest of the internal mammary artery was completed in all cases with a mean insufflation time of 44 ± 12 minutes. There were no significant changes in the mean arterial pressure, heart rate, cardiac index, and left ventricular ejection fraction throughout the procedure, whereas the central venous pressure, mean pulmonary arterial pressure, and pulmonary capillary wedge pressure (p < 0.05 for each variable) during insufflation.

Conclusions. Low-flow carbon dioxide insufflation into the left hemithorax with an intrapleural pressure of 8 to 10 mm Hg under selective right-lung ventilation does not compromise the human heart with normal to moderately depressed function and can be an efficacious adjunct in specific thoracoscopic procedures.

This article has been cited by other articles:

				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]

				V. Falk, A. Diegeler, T. Walther, J. Banusch, J. Brucerius, J. Raumans, R. Autschbach, and F. W. Mohr Total endoscopic computer enhanced coronary artery bypass grafting Eur. J. Cardiothorac. Surg., January 1, 2000; 17(1): 38 - 45. [Abstract] [Full Text] [PDF]