Carbon dioxide-insufflated colonoscopy: an ignored superior technique

Phaosawasdi, Kamthorn; Cooley, W. Carl; Wheeler, Jo; Rice, Pamela J.

doi:10.1016/s0016-5107(86)71877-4

Cited by 38 publications

(25 citation statements)

References 12 publications

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“…Indeed, the adoption rate found in the present study was even lower than that reported 20 years ago in a survey of US hospitals in Illinois (13% for colonoscopy) [15] . A majority of endoscopists…”

Section: Discussioncontrasting

confidence: 84%

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Janssens¹,

Devière²,

Eisendrath³

et al. 2009

WJG

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AIM:To assess the adoption of Carbon dioxide (CO2) insufflation by endoscopists from various European countries, and its determinants. M E T H O D S :A s u r v e y w a s d i s t r i b u t e d t o 5 8 0 endoscopists attending a live course on digestive endoscopy. RESULTS:The response rate was 24.5%. Fewer than half the respondents (66/142, 46.5%) were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy, and 4.2% of respondents were actually using CO2 as the insufflation agent. Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice (84% and 49% of answers, respectively; two answers were permitted for this item). CONCLUSION:Based on this survey, adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional. A majority of endoscopists were not aware of this possibility, while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.

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Section: Discussioncontrasting

confidence: 84%

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Janssens¹,

Devière²,

Eisendrath³

et al. 2009

WJG

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show abstract

“…This debate halted in the mid 1980s by the demonstration that full bowel preparation before colonoscopy, sufficient aspiration, and insufflation at colonoscopy removed any risk of potentially flammable gas concentrations [1,15,16]. Afterward, other advantages of CO 2 insufflation were reported such as less postprocedural abdominal pain, bloating, or discomfort after ambulatory colonoscopy [7,10,13,16]. These advantages are attributable to rapid passive absorption of CO 2 gas from the colon and its quick clearance from the lung [12].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, overdistention may decrease mucosal blood flow and potentially lead to bowel ischemia [3]. Most laparoscopic surgeons are therefore reluctant to use conventional IOC as a routine localization and screening tool during laparoscopic surgery.Recently, studies have shown the use of carbon dioxide (CO 2 ) instead of atmospheric air to be effective in reducing abdominal pain caused by persistent bowel distention after ambulatory colonoscopy [4,6,7,10,13,14,16]. This is attributable to the rapid absorptive nature of CO 2 from the colonic lining: 160 times faster than nitrogen [12].…”

mentioning

confidence: 99%

Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery

et al. 2005

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“…Dellon et al [10] reviewed 9 randomized controlled studies (6 studies of colonoscopy [1,2,11,12,13,14] and 1 study each of flexible sigmoidoscopy [15], ERCP [3], and double-balloon enteroscopy [16]) and 6 non-randomized studies [4,17,18,19,20,21] related to the safety of administering CO 2 during gastrointestinal endoscopy. Adverse respiratory complications or episodes of suppressed ventilation were not reported, although most studies excluded patients with severe respiratory compromise or COPD with known CO 2 retention.…”

Section: Discussionmentioning

confidence: 99%

Capnographic Monitoring during Endoscopic Submucosal Dissection with Patients under Deep Sedation: A Prospective, Crossover Trial of Air and Carbon Dioxide Insufflations

et al. 2011

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Background and Aims: The safety of carbon dioxide (CO₂) insufflation has not been fully established for esophageal and gastric endoscopic submucosal dissection (ESD) under deep sedation, because CO₂ retention is not only caused by CO₂ insufflation but also by the sedation level and the patient’s respiratory status. To clarify the clinical safety of CO₂ insufflation, we conducted a crossover trial of air and CO₂ insufflations. Methods: A total of 60 patients with early esophageal or gastric cancers underwent ESD during which insufflation was switched from CO₂ to air or from air to CO₂; transcutaneous partial pressure CO₂ (PtcCO₂) was monitored in all patients. We also assessed respiratory function, arterial blood gas analysis, and smoking history. Results: Although significant increases in PtcCO₂ from baseline were observed, there were no significant differences in PtcCO₂ levels during CO₂ insufflation compared with levels during air insufflation in groups that received CO₂ preceding air or air preceding CO₂. All patients underwent ESD safely without adverse events, including 20 patients with subclinical respiratory dysfunction. The sedation protocol was the only significant predictor of CO₂ retention, independent of CO₂ insufflation. Conclusions: CO₂ insufflation can be used as safely as air insufflation during ESD under deep sedation.

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Carbon dioxide-insufflated colonoscopy: an ignored superior technique

Cited by 38 publications

References 12 publications

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Carbon dioxide for gut distension during digestive endoscopy: Technique and practice survey

Intraoperative carbon dioxide colonoscopy: a safe insufflation alternative for locating colonic lesions during laparoscopic surgery

Capnographic Monitoring during Endoscopic Submucosal Dissection with Patients under Deep Sedation: A Prospective, Crossover Trial of Air and Carbon Dioxide Insufflations

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