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SHR Neuro Cancer Cardio Lipid Metab Microb
Till, H; Yeung, CK; Bower, W; Shi, Y; Tian, Q; Chu, W; Yip, HY; Tse, J.
Fetoscopy under gas amniodistension: pressure-dependant influence of helium vs nitrous oxide on fetal goats
J Pediatr Surg. 2007; 42(7):1255-1258
Doi: 10.1016/j.jpedsurg.2007.02.026
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- Leading authors Med Uni Graz
- Till Holger
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- Abstract:
- Purpose: Recently, gas amniodistension has been advocated for fetoscopic surgery to employ ergonomics similar to laparoscopy. However, neither the optimal type of gas nor its physiological influence on the fetus have been clearly outlined yet. This study investigates the impact of helium (HE) vs nitrous oxide (N2O) on fetal goats during fetoscopy. Methods: We insufflated either HE or N2O in 12 pregnant goats (15 fetuses; HE = 7, N2O = 8), then increased the pressures from 0, 4, 7, to 10mm Hg in 30-minute intervals and recorded the fetal and maternal vital parameters. Finally, whole-body computed tomography to asses for intracorporeal gas was performed. Results: All fetuses survived. Mean fetal vital signs showed no significant differences between HE or N2O at specific pressure levels. In detail, HE/N2O at 0 vs 10 mm Hg caused a fetal temperature decrease (32.9 degrees C/33.2 degrees C vs 32 degrees C/32.5 degrees C), heart rate increase in the N2O group (100/102 vs 102/121 beats per minute), and no significant change in arterial pressure (45,8/48,3 vs 53,7/46,7mmHg). The PO2 was adequate (3.7/3.3 vs 3.7/2.9 kPa), whereas the pH remained unchanged (7.4/7.3 vs 7.3/7.3). However, fetal PC0(2) was elevated in the N2O group before insufflation (5.5/7.2 vs 6.8/8.0 kPa) owing to maternal hypoventilation (maternal PCO2: 4.9/5.8 vs 5.0/5.4 kPa), correction of which was slower in the fetus than in the maternal animal. Computed tomography ruled out intracorporeal gas accumulation. Conclusion: Neither HE nor N2O impose significant physiological harm for the fetus. Heating of the gas and maternal anesthesia seem essential. Considering the potential teratogenicity of N2O, however, HE could be the favorable environment for fetoscopic procedures under gas amniodistension. (c) 2007 Elsevier Inc. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Amnion - physiology
- Animals -
- Female -
- Fetoscopy -
- Goats -
- Helium - diagnostic use
- Hydrogen-Ion Concentration -
- Insufflation - methods
- Nitrous Oxide - diagnostic use
- Pregnancy -
- Random Allocation -
- Risk Factors -
- Find related publications in this database (Keywords)
- fetoscopy
- gas amniodistension
- helium
- nitrous oxide
- goat