Hemodynamic responses to intrapleural insufflation with hemipulmonary collapse

Ohtsuka, Toshiya; Nakajima, Jun; Kotsuka, Yutaka; Takamoto, Shinichi

doi:10.1007/s00464-001-0037-z

Cited by 23 publications

(18 citation statements)

References 10 publications

(11 reference statements)

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“…Few studies have investigated the hemodynamic consequence of CO 2 insufflation, and all of these reports were done in adult thoracoscopy. 14,15 To the best of our knowledge, there has been no report concerning the cardiovascular effects of increased intrapleural pressure in the pediatric population during VATS.…”

Section: Discussionmentioning

confidence: 95%

The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients

Mukhtar¹,

Obayah²,

Elmasry³

et al. 2008

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 95%

The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients

Mukhtar¹,

Obayah²,

Elmasry³

et al. 2008

Anesthesia &Amp; Analgesia

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“…Toshiya Ohtsuka and associates had previously reported that the central venous and pulmonary capillary wedge pressures were significantly elevated and the cardiac index was decreased slightly during CO 2 insufflation with hemipulmonary collapse [7]. The present alternative method of sternum lifting was used successfully in 12 consecutive patients.…”

Section: Commentsmentioning

confidence: 79%

Sternum lifting technique for thoracoscopic internal thoracic artery harvest

Ohtsuka

Ninomiya

Maemura

2005

European Journal of Cardio-Thoracic Surgery

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We employed the Laparolift and Laparofan (Origin Medsystems Inc., CA, USA) and developed a sternum lifting technique to create a sufficient intra-pleural space between the heart and the sternum in which the left internal thoracic artery (ITA) in situ graft could be thoracoscopically mobilized. Between June and December 2004, this technique was applied to 12 consecutive patients (eight men, four women, aged 68.5+/-9.6 years) undergoing minimally invasive coronary artery bypass grafting via a left mini-thoracotomy. The Laparofan, connected to the arm of the lift machine (Laparolift), was introduced through a subxyphoidal entry and opened beneath the sternum. The sternum was elevated by about 5 cm until a sufficient working space was created under the sternum. With left hemipulmonary collapse, the left ITA was thoracoscopically taken down through the axillary ports. There was no procedural conversion to direct harvesting. The mean thoracoscopic harvesting time was 34.5+/-7.7 min. There was no mortality and no instrument-related morbidities. Patency of each ITA graft was angiographically confirmed. In conclusion, despite the limited experience, the present sternum elevation technique using the Laparolift system is a viable method for increasing the intra-pleural working space beneath the sternum during thoracoscopic ITA harvesting.

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“…Insufflation also enlarges the intrapleural space by pushing the mediastinum away from the operative field [1]. The technique is often used in thoracoscopic harvesting of the internal mammary artery.…”

Section: Discussionmentioning

confidence: 99%

Asystole following positive pressure insufflation of right pleural cavity: a case report

Forde-Thielen

Konia

2011

J Med Case Reports

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IntroductionAdverse hemodynamic effects with severe bradycardia have been previously reported during positive pressure insufflation of the right thoracic cavity in humans. To the best of our knowledge, this is the first report of asystole during thoracoscopic surgery with positive pressure insufflation.Case presentationA 63-year-old Caucasian woman developed asystole at the onset of positive pressure insufflation of her right hemithorax during a thoracoscopic single-lung ventilation procedure. Immediate deflation of pleural cavity, intravenous glycopyrrolate and atropine administration returned her heart rhythm to normal sinus rhythm. The surgery proceeded in the absence of positive pressure insufflation without any further complications.ConclusionsWe discuss the proposed mechanisms of hemodynamic instability with positive pressure thoracic insufflation, and anesthetic and insufflation techniques that decrease the likelihood of adverse hemodynamic events.

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Hemodynamic responses to intrapleural insufflation with hemipulmonary collapse

Abstract: The hemodynamic effect resulting from one-lung collapse plus low-flow CO2 insufflation at 8-10 mmHg for 30-40 min is mild in both hemithoraces, although the impact is greater on the right.

Cited by 23 publications

References 10 publications

The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients

The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients

Sternum lifting technique for thoracoscopic internal thoracic artery harvest

Asystole following positive pressure insufflation of right pleural cavity: a case report

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