Is Helium Insufflation Superior to Carbon Dioxide Insufflation in Bacteremia and Bacterial Translocation with Peritonitis?

Erenoglu, Cengiz; Akın, Mehmet; Kayaoğlu, Hüseyin Ayhan; Celenk, Tuncay; Batkin, Ahmet

doi:10.1089/109264201750162257

Cited by 10 publications

(2 citation statements)

References 16 publications

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“…Study in rats showed that pneumoperitoneum causes intestinal ischemia with oxygen free radical production and bacterial translocation, related to mechanical pressure of CO 2 17 . Other studies focused on whether a pneumoperitoneum amplifies the extent and severity of peritonitis or of bacteremia in various animal models 18,19,20,21 . Findings from these investigations are controversial.…”

Section: Discussionmentioning

confidence: 99%

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

et al. 2006

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Purpose: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO 2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO 2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO 2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals. Key words: Pneumoperitoneum. Carbon Dioxide. Sepsis. Acidosis. Leucocytes. RESUMO Objetivo:A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO 2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. Métodos: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia), laparotomia, pneumoperitôneo com CO 2 , ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFα, IL-1β e IL-6 foram dosadas no líquido intraperitoneal (por ELISA). Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos intraperitoneal e subperitoneal. Resultados: Os valores de TNFα, IL-1β e IL-6 foram significantemente menores nos ratos submetidos ao pneumoperitôneo do que em...

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Section: Discussionmentioning

confidence: 99%

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

et al. 2006

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“…[12][13][14] Some studies have shown that increased intraabdominal pressure via pneumoperitoneum may lead to the increased risk of bacterial translocation and bacteremia. [15][16][17][18][19][20][21][22][23][24][25][26] Some studies have shown that CO 2 has immunosuppressive effects on neutrophil and macrophage function, and CO 2 -induced immunosuppression might be deleterious in the setting of infection. [27,28] It has been argued as well that CO 2 pneumoperitoneum may cause malignant hypercapnia and toxic shock syndrome in the cases with peritonitis.…”

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confidence: 99%

The effect of carbondioxide pneumoperitoneum on the severity peritonitis

Uzunköy¹,

Özardalı²,

Çelik³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇJeneralize peritonit olgularında hala, laparoskopik girişimlerin güvenilirliği ile ilgili kaygılar devam etmektedir. Bu deneysel çalışmada, deneysel peritonit oluşturulan sı-çanlarda karbondioksit (CO 2 ) pnömoperitonyumun enflematuvar cevap ve peritonit şiddeti üzerine etkilerinin araş-tırılması amaçlandı. GEREÇ VE YÖNTEMÇalışmada 21 Wistar albino cinsi sıçan kullanıldı. Sıçanlar üç gruba ayrıldı. Bunlar; kontrol (grup 1), bakteriyel peritonit oluşturulan grup (grup 2) ve peritonit + CO 2 pnömo-perituan oluşturulan grup (grup 3) idi. İkinci ve üçüncü gruptaki sıçanların periton içine Escherishia coli verilerek peritonit oluşturuldu. Üçüncü gruptaki sıçanlarda CO 2 insuflasyonu ile pnömoperitonyum oluşturuldu. Sıçanlar 24 saat sonra öldürüldü, kan ve karın duvarından periton ör-neği alındı. Tüm gruplarda peritonit şiddet skoru, C-reaktif protein düzeyi ve kanda beyaz küre sayısı değerlendirildi. BULGULARPeritonit şiddet skoru, C-reaktif protein düzeyi ve kan beyaz küre sayısı, ikinci ve üçüncü gruplarda, birinci gruba göre anlamlı düzeyde yüksek bulundu (p<0,05). Üçüncü grupta değerler, ikinci gruptan anlamlı düzeyde düşük bulundu (p<0,05). SONUÇÇalışmamızın sonuçları, CO 2 pnömoperitonyumun Escherishia coli ile peritonit ve sepsis oluşturulan sıçanlarda peritonit şiddetini ve sistemik enflematuvar yanıtı azalttığı-nı göstermiştir.

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Stress response to laparoscopic surgery: a review

et al. 2004

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Is Helium Insufflation Superior to Carbon Dioxide Insufflation in Bacteremia and Bacterial Translocation with Peritonitis?

Abstract: Helium might be an alternative to CO2 insufflation in patients with peritonitis if these results are confirmed by further experimental and clinical trials.

Cited by 10 publications

References 16 publications

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

The effect of carbondioxide pneumoperitoneum on the severity peritonitis

Stress response to laparoscopic surgery: a review

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