scholarly journals Is It the pH That Matters? Challenging the Pathophysiology of Acidemia in a Case of Severe Hypercapnia Secondary to Intraoperative CO2 Insufflation

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Evan Merle ◽  
Saad Zaatari ◽  
Rory Spiegel ◽  
Mabrouk Bahloul
Keyword(s):  
Carbon Dioxide ◽  
Human Physiology ◽  
Circulatory System ◽  
Severe Case ◽  
Underlying Process ◽  
Hemodynamic Compromise ◽  
Case Summary ◽  
Blood Ph ◽  
Co2 Insufflation ◽  
Carbon Dioxide Co2

Background. Acidemia has been long thought to lead to hemodynamic compromise. While some literature to date challenges this idea, there is no consensus on this topic. Case Summary. To our knowledge, this is the most severe case of hypercapnia and acidosis due to carbon dioxide (CO2) insufflation during laparoscopy reported in the literature. Remarkably, this patient remained hemodynamically normal despite having a blood pH below 6.81. This prompts a wider discussion about the effects of blood pH on human physiology. Most patients who present acidotic are critically ill and have confounding underlying metabolic or respiratory pathophysiology driving their illness. In this case, the patient experienced no respiratory insult leading to an increase in blood CO2 but rather had CO2 iatrogenically introduced into the circulatory system, effectively detaching the deleterious effects of CO2 from the respiratory pathologies that so often cause its accumulation. Conclusion. This raises the question, in patients with severe acidosis and hemodynamic compromise, is acidosis a symptom of the underlying process, or is the acidosis itself causing harm?

scholarly journals Gastroscopy Should Come Before Colonoscopy Using CO2 Insufflation in Same Day Bidirectional Endoscopies: A Randomized Controlled Trial

2019 ◽  
Vol 3 (3) ◽  
pp. 120-126
Author(s):  
Fahd Jowhari ◽  
Lawrence Hookey
Keyword(s):  
Carbon Dioxide ◽  
Randomized Controlled Trial ◽  
Primary Outcome ◽  
Conscious Sedation ◽  
Controlled Trial ◽  
Patient Comfort ◽  
Clinical Indication ◽  
Randomized Controlled ◽  
Co2 Insufflation ◽  
Carbon Dioxide Co2

Abstract Background and Aims Same day bidirectional endoscopies (esophagogastroduodenoscopies [EGD]s and colonoscopies) are routinely performed. However, the best sequence of procedures is unknown, as is whether the use of carbon dioxide (CO2) affects the preferred sequence of procedures. This study aims to determine the preferred sequence of procedures and choice of insufflation gas (air or CO2) in patients undergoing same day bidirectional endoscopies. Methods Two hundred adults with a clinical indication for same day bidirectional endoscopies were randomized equally into four groups: A1 (EGD first, CO2 as insufflator); A2 (EGD first, air as insufflator); B1 (colonoscopy first, CO2 as insufflator); and B2 (colonoscopy first, air as insufflator). All procedures were performed with conscious sedation (Midazolam/Fentanyl). The primary outcome was patients’ overall comfort/satisfaction with the procedures and sedation received, as assessed by questionnaires and validated scoring scales (Nurse-Assessed Patient Comfort Score [NAPCOMS], La Crosse [WI]) collected during the procedures, before discharge, and on day 7 postprocedure. Results Two hundred patients were randomized, with data available for 186. Mean Midazolam dose between groups was significantly less in the EGD first groups (P=0.01). During the procedures, no differences were found in patients’ comfort as per the nurse reported NAPCOMS scores (P=0.19) or the Lacrosse (WI) endoscopy scores (P=0.05). On postprocedure days 0 and 7, no differences were found in the patients’ reported Lacrosse (WI) scores, nausea, sore throat, dizziness, satisfaction with sedation or overall level of procedural satisfaction (P>0.05 for each). However, bloating and discomfort were significantly lower in the CO2 arms (P<0.001). Conclusions This randomized controlled trial using validated patient comfort scoring assessments for same day bidirectional endoscopies demonstrated that the sequence of procedures affects the sedation used but does not affect overall patient comfort or satisfaction. Lesser sedation is needed in the EGD first group, and less postprocedural abdominal pain/discomfort and bloating is seen with CO2 insufflation.

Carbon Dioxide (CO2) Insufflation during ERCP for the Reduction of Post-procedure Pain: Preliminary Results of a Randomized, Double-blind Controlled Trial

2008 ◽  
Vol 67 (5) ◽  
pp. AB107 ◽  
Author(s):  
Rajesh N. Keswani ◽  
Robert M. Hovis ◽  
Steven A. Edmundowicz ◽  
Esmat Z. Sadeddin ◽  
Sreenivasa S. Jonnalagadda ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Controlled Trial ◽  
Double Blind ◽  
Preliminary Results ◽  
Post Procedure ◽  
Co2 Insufflation ◽  
Carbon Dioxide Co2

scholarly journals Examination of carbon dioxide (CO2) insufflation during colonoscopy

2011 ◽  
Vol 78 (2) ◽  
pp. 57-60
Author(s):  
Masayuki Inui ◽  
Susumu Ohwada ◽  
Yuko Kondou ◽  
Naondo Sohara ◽  
Yoshikatsu Inui
Keyword(s):  
Carbon Dioxide ◽  
Co2 Insufflation ◽  
Carbon Dioxide Co2

PERANCANGAN PROTEKSI KEBAKARAN OTOMATIS PADA KAPAL BERBASIS ARDUINO

2018 ◽  
Vol 1 (2) ◽  
pp. 1-8
Author(s):  
Dody Hidayat
Keyword(s):  
Carbon Dioxide ◽  
Fire Extinguisher ◽  
Carbon Dioxide Co2

Kebakaran dapat terjadi dimana saja salah satunya dapat terjadi di alat transportasi air yakni kapal. Kebakaran selalu menyebabkan hal-hal yang tidak diinginkan baik kerugian material maupun ancaman keselamatan jiwa manusia. Seiring dari kejadian tersebut musibah kecelakaan kapal yang disebabkan oleh bahaya kebakaran sangatlah mungkin terjadi. Salah satu yang dapat mencegah kejadian kebakaran pada kapal haruslah dapat mendeteksi dini kebakaran tersebut. Untuk mendeteksi dini terjadinya kebakaran dikapal maka dirancanglah sebuah alat proteksi kebakaran otomatisberbasis adruino. Dimana Arduino merupakan board yang memiliki sebuah mikrokontroller sebagai  otak kendali sistem. Sistem otomatisasi atau controller tidak akan terlepas dengan apa yang disebut  dengan ‘sensor’. Sensor adalah sebuah alat untuk mendeteksi atau mengukut sesuatu yang digunakan untuk mengubah variasi mekanis, magnetis, panas, sinar dan kimia menjadi tegangan dan arus listrik. sistem yang dirancang ini dilengkapi dengan beberapa sensor diantaranya adalah sensor apiUV-Tron R2868, sensor asap MQ-2 dan kemudian sensor suhuDS18B20. Mikrokontroller sebagai pengendali akan merespon input yang berupa sensor tersebut ketika data yang dibaca oleh sensor mendeteksikebakaran diantaranya mendeteksi adanya asap, kemudian api dan suhu. Sebagai output dari sistem berupa racun api (fire extinguisher)dimana kandungan yang ada pada racun api tersebut berupa Dry Chemical Powder dan Carbon Dioxide (CO2) yang fungsinya digunakan untuk memadamkan api serta dilengkapi buzzer sebagai alarm peringatan jika terjadi kebakaran. 

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