Gas improves blood flow and organ status during minimally invasive surgery

Dec 14, 2009

As good as laparoscopy is in preventing some of the stresses of open surgery on the body, it does have drawbacks, including reduced blood flow and organ dysfunction. Laparoscopy is a type of surgery in the abdomen done through small incisions.

By adding another gas to the carbon dioxide used to inflate the surgical area during laparoscopy, researchers at Duke University Medical Center have found they can preserve more normal during noninvasive surgery.

The gas ethyl nitrite (ENO) helped to open blood vessels and keep blood flowing, which kept organs functioning normally during laparoscopy on pigs. The researchers did not complete any medical procedures on the pigs, which are similar in size and anatomy to humans. They merely created a laparoscopy situation by inflating the belly with carbon dioxide gas mixed with ENO. They then measured changes in heart rate, arterial pressure, cardiac output, organ blood flow, and certain chemical parameters like creatinine, a measure of kidney function, and cortisol, a stress-related hormone.

"We didn't see any downside to using ethyl nitrite during this study of minimally invasive surgery," said senior author James D. Reynolds, Ph.D., an associate professor of anesthesiology and member of the Duke Endosurgery Center. The study was published in the December issue of the journal CTS: Clinical and Translational Science.

"ENO has previously been administered to humans with no observed adverse effects, so it should be relatively easy to move this idea into a surgical clinical trial," Reynolds said.

By preserving blood flow and organ status, the use of ENO could improve outcomes and reduce the time of in-hospital recovery, he said. "It is promising news for surgical patients."

During the study, the research team determined that CO2 inflation produces "acute reductions in nitric oxide (NO) bioactivity," Reynolds said. Nitric oxide is now being recognized as the third vital blood gas in the body, along with oxygen and carbon dioxide. A reduction in its bioactivity can lead to reduced organ blood flow and a rise in markers of acute tissue injury.

"Including an agent like ethyl nitrite restored the NO bioactivity, which is then conveyed by the red blood cells to increase blood flow," Reynolds said. The team tested several different concentrations of ENO (1-300 parts per million) and found 10 ppm to be optimal.

Reynolds, who is also the chair of the Duke Institutional Animal Care and Use Committee, said that in the current study, adding ENO especially helped kidneys stay healthy. ENO kept serum creatinine and blood urea nitrogen concentrations constant, while in the group of animals inflated with gas without ENO, both indicators increased, indicating a decline in .

Source: Duke University Medical Center (news : web)

Explore further: Two Michigan high school students develop screening tools to detect lung and heart disease

add to favorites email to friend print save as pdf

Related Stories

Inhaling nitric oxide helps transplant success

Aug 30, 2007

Administering inhaled nitric oxide (NO) during surgery helps protect liver transplant patients from organ failure, according to a new study from researchers at the University of Alabama at Birmingham (UAB).

Oral contraceptives may benefit women with asthma

Nov 05, 2009

New research shows that during natural menstrual cycles, women with asthma who were not taking oral contraceptives (OC) had lower exhaled nitric oxide levels (eNO), a marker of airway inflammation associated with asthma, ...

New therapy could preserve vessel function after heart attack

Sep 10, 2007

Scientists have identified the process that causes blood vessels to constrict during and after a heart attack. They've also demonstrated that delivering a vital molecule that is depleted during this process directly to those ...

Researchers discover new hemoglobin function

Nov 05, 2007

A team of researchers from Wake Forest University, the National Institutes of Health and other institutions has discovered a previously undetected chemical process within the oxygen-carrying molecule hemoglobin that could ...

Novel compound may lessen heart attack damage

Feb 07, 2008

A novel drug designed to lessen muscle damage from a heart attack has passed initial safety tests at the Duke Clinical Research Institute. Results of the study, available online and to be published in the February 19 issue ...

Recommended for you

Team untangles the biological effects of blue light

9 hours ago

Blue light can both set the mood and set in motion important biological responses. Researchers at the University of Pennsylvania's School of Medicine and School of Arts and Sciences have teased apart the ...

Mouse model provides new insight in to preeclampsia

10 hours ago

Worldwide, preeclampsia is a leading cause of maternal deaths and preterm births. This serious pregnancy complication results in extremely high blood pressure and organ damage. The onset of preeclampsia is associated with ...

User comments : 0