Nanotubes, Carbon ; adverse effects ; chemistry

Clinically significant carbon dioxide embolism is a rare but potentially fatal complication of anesthesia administered during laparoscopic surgery. Its most common cause is inadvertent injection of carbon dioxide into a large vein, artery or solid organ. This error usually occurs during or shortly after insufflation of carbon dioxide into the body cavity, but may result from direct intravascular insufflation of carbon dioxide during surgery. Clinical presentation of carbon dioxide embolism ranges from asymptomatic to neurologic injury, cardiovascular collapse or even death, which is dependent on the rate and volume of carbon dioxide entrapment and the patient's condition. We reviewed extensive literature regarding carbon dioxide embolism in detail and set out to describe the complication from background to treatment. We hope that the present work will improve our understanding of carbon dioxide embolism during laparoscopic surgery.
Carbon Dioxide/*adverse effects ; Embolism, Air/*diagnosis/epidemiology/prevention & control/surgery ; Humans ; Insufflation/adverse effects ; Laparoscopy/*adverse effects

Animals ; Carbon Disulfide ; adverse effects ; Light ; Male ; Neurons ; drug effects ; radiation effects ; Noise ; adverse effects ; Rats ; Rats, Sprague-Dawley

In this study, we investigated the effect of different values of intra-abdominal pressure on bacterial translocation. Twenty-four Wistar-Albino rats were divided into four groups. The animals belonging to the Control group were not subjected to any increased intra-abdominal pressure. In groups I, II and III, an intra-abdominal pressure of 14, 20, and 25 mmHg, respectively, was established by carbon dioxide pneumoperitoneum for a period of 60 minutes. Four hours after the pneumoperitoneum, all animals were sacrificed to evaluate the degree of bacterial translocation at this time. Liver, spleen and mesenteric lymph nodes were excised under sterile conditions. Bacterial growth was assessed using standard bacteriological techniques and compared statistically. The Kruskal-Wallis and Mann-Whitney U tests were used for the statistical analysis. Different amounts of bacterial growth were found in all of the animals subjected to increased intra-abdominal pressure, except for the controls. Bacterial translocation was detected at an intra-abdominal pressure of 14 mmHg but this finding was not statistically significant (p > 0.05). There was a significant increase in bacterial growth in animals subjected to an intra- abdominal pressure of 20 mmHg or above (p < 0.001). As a result, we found that bacterial translocation started when the intra-abdominal pressure reached a level of 14 mmHg. Patients should be closely monitored for septic complication risks following laparoscopic procedures in which the intra-abdominal pressure exceeds 20 mmHg.
Abdomen ; Animals ; *Bacterial Translocation ; Carbon Dioxide ; Laparoscopy/*adverse effects ; Pneumoperitoneum, Artificial/adverse effects ; Pressure ; Rats ; Rats, Wistar ; Splanchnic Circulation

Carbon Dioxide ; Cardiopulmonary Resuscitation ; Echocardiography, Transesophageal ; Embolism, Air ; etiology ; therapy ; Female ; Humans ; Laparoscopy ; adverse effects ; Middle Aged ; Nephrectomy ; adverse effects

Carbon Monoxide Poisoning ; etiology ; Humans ; Industry ; Male ; Occupational Diseases ; etiology ; Occupational Exposure ; adverse effects

INTRODUCTION: Laryngeal mask airway (LMA), which is used in difficult airway maintenance conditions during emergencies, is rarely used in prolonged surgery despite its advantages over endotracheal tube (ETT). In this study, we conducted a comparative analysis of intraoperative gas exchanges between second-generation LMA and ETT during prolonged laparoscopic abdominal surgery. METHODS: Prolonged surgery was defined as a surgery lasting more than 2 h. In total, 394 patients who underwent laparoscopic liver resection via either second-generation LMA or ETT were retrospectively analysed. The following parameters were compared between the two groups of patients: end-tidal pressure of carbon dioxide (ETCO₂), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (PIP), arterial partial pressure of carbon dioxide (PaCO₂), pH and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery. In addition, the incidence of postoperative pulmonary complications (PPCs), including pulmonary aspiration, was compared. RESULTS: The values of ETCO₂, TV, RR and PIP during pneumoperitoneum were comparable between the two groups. Although PaCO₂ at 2 h after induction was higher in patients in the LMA group (40.5 vs. 38.5 mmHg, P < 0.001), the pH and PFR values of the two groups were comparable. The incidence of PPC was similar. CONCLUSION During prolonged laparoscopic abdominal surgery, second-generation LMA facilitates adequate intraoperative gas exchange and may serve as an alternative to ETT.
Humans ; Laryngeal Masks ; Carbon Dioxide ; Retrospective Studies ; Intubation, Intratracheal ; Laparoscopy/adverse effects* ; Postoperative Complications/etiology* ; Oxygen

OBJECTIVETo evaluate the effect of carbon disulfide (CS2) exposure during the peri-implantation period on the levels of calcitonin (CT) and progesterone (P4) in the uterus of pregnant mice and to investigate the mechanism of embryo loss induced by CS2 exposure during the peri-implantation period.

METHODSA total of 168 healthy pregnant Kunming mice were randomly assigned to receive an intraperitoneal injection of CS2 (631.4 mg/kg) or olive oil (control) on gestational day (GD) 3, GD4, GD5, or GD6. The experiment was completed at different end points (GD4, GD5, GD6, GD7, and GD9). The levels of CT and P4 in the uterus were measured by enzyme-linked immunosorbent assay at each end point.

RESULTSThe numbers of implanted embryos in GD3, GD4, GD5, and GD6 exposure groups significantly decreased by 42.85%, 63.74%, 60.45%, and 47.26%, respectively,compared with those in control group (P < 0.01). The GD3, GD4, GD5, and GD6 exposure groups had significantly decreased CT levels at each end point (P < 0.05), and the GD3, GD4, and GD5 exposure groups had significantly decreased P4 levels (P < 0.05). In the GD3, GD4, GD5, and GD6 exposure groups, the number of implanted embryos was positively related with the levels of CT and P4 expressed in the uterus (r = 0.670, P < 0.01; r = 0.632, P < 0.01); the expression level of CT was positively related with that of P4 in the uterus of pregnant mice (r = 0.325, P < 0.01).

CONCLUSIONExposure to CS2 during the peri-implantation period can reduce the expression levels of CT and P4 in the uterus of pregnant mice, which might be one of the molecular mechanisms of embryo loss induced by CS2 exposure.

Animals ; Calcitonin ; metabolism ; Carbon Disulfide ; adverse effects ; Embryo Implantation ; Female ; Maternal Exposure ; adverse effects ; Mice ; Mice, Inbred Strains ; Pregnancy ; Progesterone ; metabolism ; Uterus ; drug effects ; metabolism

A 45-year-old Korean woman visited our hospital complaining of poor vision after carbon monoxide (CO) poisoning. We have confirmed the presence of a point mutation at position 11778 in the ND4 gene of mitochondrial DNA. This case suggests that CO poisoning may precipitate the clinical expression of Leber's hereditary optic neuropathy (LHON). To our knowledge, this would be the first case report of clinical expression of LHON precipitated by CO poisoning.
Carbon Monoxide/adverse effects ; Carbon Monoxide Poisoning/*complications ; DNA Damage ; DNA, Mitochondrial/genetics ; Female ; Humans ; Middle Aged ; Optic Atrophies, Hereditary/*etiology/genetics ; *Point Mutation ; Visual Acuity

Abortion, Missed ; chemically induced ; Adult ; Carbon Disulfide ; adverse effects ; Female ; Humans ; Occupational Exposure ; adverse effects ; Pregnancy ; Retrospective Studies ; Risk Factors ; Time Factors