An adequate exposure is important in thoracoscopic procedures. The insufflation of CO2 has been demonstrated to aid in compressing lung parenchyma, and act as a retractor when combined with changes in patient's position. However, a recent study
demonstrated that CO2 insufflation during thoracoscopy in the pig has adverse hemodynamic consequences. We prospectively studied 12 patients undergoing thoracoscopy to evaluate the effect of CO2 insufflation in the clinicla setting. The mean
arterial
pressure, heart rate, central venous pressure, arterial oxygen saturation, and end-tidal CO2 pressure were monitored. Measurements were determined at baseline, at the initiation of one-lung ventilation, and at intrapleural pressure of 5, 10,
15mmHg
and
following results were obtained.
@EN 1) The insufflation of 5 to 15mmHg of CO2 had no significant effect on the mean arterial pressure, heart rate, arterial oxygen saturation.
2) The end-tidal CO2 pressure rose from 31.00±1.67 mmHg to 38.49±1.82mmHg at an intrapleural pressure of 15 mmHg(p<0.05).
3) The central venous pressure rose from 7.75±0.76mmHg to 12.83±1.64mmHg and 16.16±1.97mmHg at intrapleural pressure of 10 and 15mmhg(p<0.05).
4) The low pressure(<10mmHg)insufflation is a safe adjunct to the conduct of thoracoscopic surgical procedures.
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