Abdominal Insufflation Decreases Blood Loss and Mortality after Porcine Liver Injury

Jaskille, Amín D.; Schechner, Adam; Park, Ken; Williams, Michael J.A.; Wang, Dennis; Sava, Jack

doi:10.1097/01.ta.0000198374.16218.ca

Cited by 26 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other influences on this gradient include pretransection ligation of ipsilateral vessels, use of inflow occlusion or other techniques of vascular control, and patient positioning. Interestingly, positive pressure pneumoperitoneum has been shown to decrease blood loss from liver trauma in an animal model [18]. The counterpressure exerted by pneumoperitoneum can contribute to hemostasis during LH by tamponade [19].…”

Section: Discussionmentioning

confidence: 99%

The association between central venous pressure, pneumoperitoneum, and venous carbon dioxide embolism in laparoscopic hepatectomy

et al. 2009

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The association between central venous pressure, pneumoperitoneum, and venous carbon dioxide embolism in laparoscopic hepatectomy

et al. 2009

View full text Add to dashboard Cite

show abstract

“…10 Subsequently, abdominal insufflation was evaluated in a swine model of a grade V hepatic laceration created by a captive bolt gun. 11 The blood loss was 69% lower in the animals insufflated with CO 2 compared with the control animals. 11 Furthermore, mortality was 0% in the treatment group compared with 30% in the control group.…”

Section: Gas Insufflationmentioning

confidence: 83%

Emerging Therapies for Prehospital Control of Hemorrhage

Klein

Tsihlis

Pritts

et al. 2020

Journal of Surgical Research

View full text Add to dashboard Cite

Background: The aim of this review was to describe emerging therapies that could serve as a prehospital intervention to slow or stop noncompressible torso hemorrhage in the civilian and military settings. Hemorrhage accounts for 90% of potentially survivable military deaths and 30%-40% of trauma deaths. There is a great need to develop novel therapies to slow or stop noncompressible torso hemorrhage at the scene of the injury. Methods: A comprehensive literature search was performed using PubMed (1966 to present) for therapies not approved by the Food and Drug Administration for noncompressible torso hemorrhage in the prehospital setting. Therapies were divided into compressive versus intravascular injectable therapies. Ease of administration, skill required to use the therapy, safety profile, stability, shelf-life, mortality benefit, and efficacy were reviewed. Results: Multiple potential therapies for noncompressible torso hemorrhage are currently under active investigation. These include (1) tamponade therapies, such as gas insufflation and polyurethane foam injection; (2) freeze-dried blood products and alternatives such as lyophilized platelets; (3) nanoscale injectable therapies such as polyethylene glycol nanospheres, polyethylenimine nanoparticles, SynthoPlate, and tissue factoretargeted nanofibers; and (4) other injectable therapies such as polySTAT and adenosine, lidocaine, and magnesium. Although each of these therapies shows great promise at slowing or stopping hemorrhage in animal models of noncompressible hemorrhage, further research is needed to ensure safety and efficacy in humans. Conclusions: Multiple novel therapies are currently under active investigation to slow or stop noncompressible torso hemorrhage in the prehospital setting and show promising results.

show abstract

“…Indeed, the vascular pressure along the liver stump is related to the inflow (decreased by clamping), the outflow (decreased by low central venous pressure) and the counter pressure of pneumoperitoneum. Jaskille et al [53] have even shown that the positive pressure of the pneumoperitoneum could decrease blood loss after liver trauma in an animal model. However, a theoretical risk of CO 2 embolism exists by using a positive pressure pneumoperitoneum with a low central venous pressure, causing a pressure gradient in the venous circulation [54].…”

Section: Discussionmentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

View full text Add to dashboard Cite

Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

show abstract

Abdominal Insufflation Decreases Blood Loss and Mortality after Porcine Liver Injury

Abstract: In a swine model of catastrophic blunt hepatic injury, abdominal insufflation significantly decreased blood loss and mortality.

Cited by 26 publications

References 9 publications

The association between central venous pressure, pneumoperitoneum, and venous carbon dioxide embolism in laparoscopic hepatectomy

The association between central venous pressure, pneumoperitoneum, and venous carbon dioxide embolism in laparoscopic hepatectomy

Emerging Therapies for Prehospital Control of Hemorrhage

Bleeding control during laparoscopic liver resection: a review of literature

Contact Info

Product

Resources

About