Renal effects of CO2 insufflation: Oliguria and acute renal dysfunction in a rat pneumoperitoneum model

Kirsch, Andrew J.; Hensle, Terry W.; Chang, David T.; Kayton, Mark L.; Olsson, Carl A.; Sawczuk, Ihor S.

doi:10.1016/0090-4295(94)90230-5

Cited by 188 publications

(126 citation statements)

References 15 publications

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“…Once again, no difference was found between CO 2 and helium, indicating that both gases had similar effects on urine concentration. Similar levels of serum sodium, urea and creatinine between PP and control groups have also been reported elsewhere 4,8,16 . Serum potassium increased in the helium and CO 2 groups, although statistical significance was only reached in the latter.…”

Section: Discussionsupporting

confidence: 59%

“…Both groups subjected to PP exhibited oliguria, an effect repeatedly reported in previous studies [4][5][6][7][8][9][10][11]16 . No difference was observed regardless of whether CO 2 or helium was used for insufflation.…”

Section: Discussionsupporting

confidence: 49%

“…A 12 mmHg pneumoperitoneum was chosen to warrant some degree of renal impairment, based on the experiments performed in rats by Kirsch et al 8 . Thus any difference between CO 2 and Helium would become evident.…”

Section: Discussionmentioning

confidence: 99%

“…Carbon dioxide (CO 2 ) is the gas employed most widely for insufflation, given that it is noncombustible, relatively inexpensive and highly soluble in blood, minimizing the risk of embolism [2][3]6 . However, PP increases intra-abdominal pressure, which has been shown to produce oliguria and renal dysfunction in both animal and clinical studies [1][2][4][5][6][7][8][9][10][11][12] . In healthy young patients, these changes tend to be mild and reversible due to the various physiologic mechanisms for CO 2 buffering and elimination 2,12 .…”

Section: Introductionmentioning

confidence: 99%

“…They include persistence of renal changes for some hours after desufflation [1][2]5,[8][9][10][11] , increased renin activity in dogs following CO 2 (but not helium) insufflation 10 and higher vasopressin levels 7,10 , as well as complete oliguria, reversed with N-acetylcysteine 9 or a vasopressin receptor antagonist 7 . Histopathological changes have also been assessed, although they are reported only occasionally in the literature 2,4,11,[13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

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Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Freitas¹,

Durães²,

Carvalho³

et al. 2013

Acta Cir. Bras.

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PURPOSE:To evaluate the effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in a rat model. METHODS:Twenty four rats were randomized into three groups (n=8): gasless insufflation ('open', Pressure=0 mmHg), carbon dioxide pneumoperitoneum at 12 mmHg, and helium pneumoperitoneum at 12 mmHg; all lasting 90 minutes.. A cystostomy was performed and the bladder was emptied. At the end of the experiment, the urine produced, a blood sample and the left kidney of each animal were collected. The following variables were obtained: serum sodium, potassium, urea and creatinine, urine volume and creatinine. The creatinine clearance was estimated for each animal. The kidneys were stained with hematoxylin and eosin (HE) and evaluated by a pathologist blinded to the groups. RESULTS:The CO 2 and Helium groups did not differ in the variables evaluated. Both developed oliguria (p<0.001 vs. gasless). The CO 2 group presented hyperkalemia compared to gasless (p=0.05), which did not attain significance in the helium group. Histopathological analysis revealed mild hydropic degeneration and congestion in the three groups, with no significant difference among them. CONCLUSIONS:The type of gas resulted in no difference in the variables of renal function and morphology assessed. The increase in serum potassium was only observed with CO 2 insufflation suggests a combined effect of elevated intra-abdominal pressure and metabolic effects of pneumoperitoneum.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Freitas¹,

Durães²,

Carvalho³

et al. 2013

Acta Cir. Bras.

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Antidiuretic Hormone Release During Laparoscopic Donor Nephrectomy

Hazebroek

Cappel²,

Gommers³

et al. 2002

Archives of Surgery

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Background: During laparoscopic procedures, increased intra-abdominal pressure may cause transient renal dysfunction due to impaired renal blood flow and induction of neurohormones. However, the relationship between antidiuretic hormone (ADH) secretion and increased intra-abdominal pressure is poorly understood. Hypothesis: Laparoscopic donor nephrectomy (LDN) is associated with an increase in plasma ADH concentration, which influences renal function in both the donor and transplanted graft. Objectives: To evaluate plasma ADH levels during LDN and to correlate ADH levels with graft function. Design and Interventions: In 30 patients who underwent LDN, plasma ADH levels were collected before insufflation, during surgery, after desufflation, and 24 hours after the procedure. In 6 patients who had open donor nephrectomy, blood samples were obtained as controls. Furthermore, graft function, operative characteristics, and clinical outcome were compared. Setting: University hospital. Results: In the LDN group, mean ADH levels during pneumoperitoneum and 30 minutes postinsufflation were significantly higher compared with preinsufflation values (PϽ.001). Twenty-four hours after LDN, mean ADH levels had returned to normal values. There were no significant differences in ADH levels in the open donor nephrectomy group. No significant differences in either intraoperative diuresis, blood pressure readings, or postoperative graft function were documented among the 2 groups. Conclusions: In this study, LDN was associated with an increase in plasma ADH that appeared to be related to increased intra-abdominal pressure. We conclude that the increased ADH concentrations during LDN are not associated with clinically significant changes in either the kidney donor or the transplanted graft.

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Pathophysiologic effects of prolonged laparoscopic operation

Wolf

1996

Semin. Surg. Oncol.

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Renal effects of CO2 insufflation: Oliguria and acute renal dysfunction in a rat pneumoperitoneum model

Cited by 188 publications

References 15 publications

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Antidiuretic Hormone Release During Laparoscopic Donor Nephrectomy

Pathophysiologic effects of prolonged laparoscopic operation

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