Inclusion of a nitric oxide congener in the insufflation gas repletes S-nitrosohemoglobin and stabilizes physiologic status during prolonged carbon dioxide pneumoperitoneum.
Inclusion of a nitric oxide congener in the insufflation gas repletes S-nitrosohemoglobin and stabilizes physiologic status during prolonged carbon dioxide pneumoperitoneum.
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DOI：
10.1111/j.1752-8062.2009.00154.x
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Reynolds JD
中科院分区：
文献类型：
--
作者：
Shimazutsu K;Uemura K;Auten KM;Baldwin MF;Belknap SW;La Banca F;Jones MC;McClaine DJ;McClaine RJ;Eubanks WS;Stamler JS;Reynolds JD
在腹腔镜手术中维持器官血流的方法还没有开发出来。在这里，我们确定了亚硝酸乙酯，一种S-亚硝酸盐，将保持一氧化氮生物活性(组织灌流的主要调节因子)，是否可能是在长时间气腹期间保持生理状态的有效干预措施。本实验在麻醉成年猪上进行，气腹时间为240分钟。队列包括麻醉对照组和单独注射二氧化碳或含有固定数量的亚硝酸乙酯(1-300ppm)的二氧化碳的组。单独注射二氧化碳会导致内脏器官血流量下降，并降低循环中S-亚硝酸血红蛋白的水平(即一氧化氮生物活性)；这些减少被亚硝酸乙酯所消除。在一个特定的例子中，用亚硝酸乙酯保存肾脏血流使血清肌酐和血尿素氮浓度保持不变，而在单独使用二氧化碳的组中，两者都随着肾脏血流量的下降而增加。这些数据表明，亚硝酸乙酯可以有效地减轻气腹引起的器官血流量和一氧化氮生物活性的下降，从而导致急性组织损伤标志物的减少。这一简单的干预提供了一种控制与腹腔镜相关的发病率和死亡率的主要来源：组织缺血和术后器官功能改变的方法。
A method to maintain organ blood flow during laparoscopic surgery has not been developed. Here we determined if ethyl nitrite, an S-nitrosylating agent that would maintain nitric oxide bioactivity (the major regulator of tissue perfusion), might be an effective intervention to preserve physiologic status during prolonged pneumoperitoneum. The study was conducted on appropriately anesthetized adult swine; the period of pneumoperitoneum was 240 minutes. Cohorts consisted of an anesthesia control group and groups insufflated with CO2 alone or CO2 containing fixed amounts of ethyl nitrite (1–300 ppm). Insufflation with CO2 alone produced declines in splanchnic organ blood flows and it reduced circulating levels of S-nitrosohemoglobin (i.e., nitric oxide bioactivity); these reductions were obviated by ethyl nitrite. In a specific example, preservation of kidney blood flow with ethyl nitrite kept serum creatinine and blood urea nitrogen concentrations constant whereas in the CO2 alone group both increased as kidney blood flow declined. The data indicate ethyl nitrite can effectively attenuate insufflation-induced decreases in organ blood flow and nitric oxide bioactivity leading to reductions in markers of acute tissue injury. This simple intervention provides a method for controlling a major source of laparoscopic-related morbidity and mortality: tissue ischemia and altered postoperative organ function.
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DOI：
10.1073/pnas.0409876102
发表时间：
2005-02-15
影响因子：
11.1
作者：
Pawloski, JR;Hess, DT;Stamler, JS
通讯作者：
Stamler, JS
影响因子：
9
作者：
Ali, NA;Eubanks, WS;Reynolds, JD
通讯作者：
Reynolds, JD
影响因子：
37.8
作者：
Datta, B;Tufnell-Barrett, T;James, P
通讯作者：
James, P
影响因子：
82.9
作者：
McMahon, TJ;Moon, RE;Stamler, JS
通讯作者：
Stamler, JS
影响因子：
2.7
作者：
Razvi, HA;Fields, D;Sosa, E
通讯作者：
Sosa, E