[Effects of carbon dioxide insufflation during endoscopic conduit harvesting in coronary artery bypass surgery].

Abstract

BACKGROUND:

Endoscopic vessel harvesting is becoming common for the patients undergoing coronary artery bypass grafting. Insufflation of carbon dioxide (CO2) during the procedures has been reported elsewhere to affect arterial carbon dioxide tension, but the occurrence of hypercapnia is still controversial.

METHODS:

We investigated the effects of CO2 insufflation during endoscopic harvesting of the saphenous vein (SV, n = 34), radial artery (RA, n = 14), or internal mammary artery (IMA, n = 7) for coronary artery bypass surgery. The conduit harvesting was performed using Vasoview Dissecting Cannula with insufflation of CO2 maintaining a cavity pressure of 8-10 mmHg.

RESULTS:

After insufflation of CO2, significant elevation of partial pressure of CO2 in arterial blood (PaCO2) was found during harvesting of SV (35.4 +/- 3.8 to 49.2 +/- 7.5 mmHg, P < 0.01) and of IMA (38.0 +/- 2.3 to 44.2 +/- 3.2 mmHg, P < 0.05), but no significant elevation of PaCO2 occurred during RA harvesting using a tourniquet. The extent of PaCO2 elevation in SV harvesting showed negative correlation with patient's body weight, body mass index, and body surface area.

CONCLUSIONS:

Significant hypercarbia occurs during endoscopic harvesting of SV or IMA. It is recommended that PaCO2 should be carefully monitored during endoscopic conduit harvesting for coronary artery bypass surgery.

• Authors: Tomofumi Suzuki, Toshiyuki Oda, Yoshito Takagi, Minoru Fukuda, Satoshi Inoue, Aguru Mochizuki, Kaori Fujita
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 55 Issue 7 Pg. 892-6 (Jul 2006) ISSN: 0021-4892 [Print] Japan
• PMID: 16856551 (Publication Type: English Abstract, Journal Article)

Chemical References

• Carbon Dioxide

Topics

• Aged
• Angioscopy
• Carbon Dioxide (metabolism)
• Coronary Artery Bypass
• Female
• Humans
• Insufflation
• Male
• Mammary Arteries (surgery)
• Middle Aged
• Partial Pressure
• Radial Artery (surgery)
• Saphenous Vein (surgery)
• Tissue and Organ Harvesting (methods)