Nitrous oxide amniodistention compared with fluid amniodistention reduces operation time while inducing no changes in fetal acid-base status in a sheep model for endoscopic fetal surgery

2002 ◽  
Vol 186 (3) ◽  
pp. 538-543 ◽  
Author(s):  
Eduard Gratacós ◽  
Jun Wu ◽  
Roland Devlieger ◽  
Francesca Bonati ◽  
Toni Lerut ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Fetal Surgery ◽  
Operation Time ◽  
Acid Base ◽  
Sheep Model ◽  
Acid Base Status

scholarly journals Contrast‐enhanced ultrasound imaging can be used to evaluate fetal cerebral perfusion: potential implications for fetal surgery

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kendall M. Lawrence ◽  
Barbara E. Coons ◽  
Anush Sridharan ◽  
Avery C. Rossidis ◽  
Marcus G. Davey ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cerebral Perfusion ◽  
Fetal Surgery ◽  
Time Dependent ◽  
Contrast Enhanced Ultrasound ◽  
Acid Base ◽  
Fetal Sheep ◽  
Contrast Enhanced ◽  
Support Device ◽  
Acid Base Status

Abstract Background Fetal surgery is increasingly performed to correct congenital defects. Currently, fetal brain perfusion cannot be assessed intra-operatively. The purpose of this study was to determine if contrast-enhanced ultrasound (CEUS) could be used to monitor fetal cerebral perfusion during fetal surgery and if parameters correlate with fetal hemodynamics or acid/base status. Methods Cannulated fetal sheep were insufflated with carbon dioxide gas in an extra-uterine support device and in utero to mimic fetal surgery. Fetal heart rate, mean arterial pressure, and arterial blood gases were serially measured. CEUS examinations of the brain were performed and time-dependent metrics were quantified to evaluate perfusion. The relationships between measured parameters were determined with mixed linear effects models or two-way repeated measures analysis of variance. Results 6 fetal sheep (113 ± 5 days) insufflated at multiple time-points (n = 20 experiments) in an extra-uterine support device demonstrated significant correlations between time-dependent perfusion parameters and fetal pH and carbon dioxide levels. In utero, 4 insufflated fetuses (105 ± 1 days) developed hypercarbic acidosis and had reductions in cerebral perfusion parameters compared to age-matched controls (n = 3). There was no significant relationship between cerebral perfusion parameters and fetal hemodynamics. Conclusions CEUS-derived cerebral perfusion parameters can be measured during simulated fetal surgery and strongly correlate with fetal acid/base status.

scholarly journals Contrast-enhanced Ultrasound Imaging Can be Used to Evaluate Fetal Cerebral Perfusion: Potential Implications for Fetal Surgery

2020 ◽  
Author(s):  
Kendall M Lawrence ◽  
Barbara E Coons ◽  
Anush Sridha ◽  
Avery C Rossidis ◽  
Marcus G Davey ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cerebral Perfusion ◽  
Fetal Surgery ◽  
Time Dependent ◽  
Contrast Enhanced Ultrasound ◽  
Acid Base ◽  
Fetal Sheep ◽  
Contrast Enhanced ◽  
Support Device ◽  
Acid Base Status

Abstract Background: Fetal surgery is increasingly performed to correct congenital defects. Currently, fetal brain perfusion cannot be assessed intra-operatively. The purpose of this study was to determine if contrast-enhanced ultrasound (CEUS) could be used to monitor fetal cerebral perfusion during fetal surgery and if parameters correlate with fetal hemodynamics or acid/base status. Methods: Cannulated fetal sheep were insufflated with carbon dioxide gas in an extra-uterine support device and in utero to mimic fetal surgery. Fetal heart rate, mean arterial pressure, and arterial blood gases were serially measured. CEUS examinations of the brain were performed and time-dependent metrics were quantified to evaluate perfusion. The relationships between measured parameters were determined with mixed linear effects models or two-way repeated measures analysis of variance. Results: 6 fetal sheep (113 ± 5 days) insufflated at multiple time-points (n=20 experiments) in an extra-uterine support device demonstrated significant correlations between time-dependent perfusion parameters and fetal pH and carbon dioxide levels. In utero, 4 insufflated fetuses (105 ± 1 days) developed hypercarbic acidosis and had reductions in cerebral perfusion parameters compared to age-matched controls (n=3). There was no significant relationship between cerebral perfusion parameters and fetal hemodynamics. Conclusions: CEUS-derived cerebral perfusion parameters can be measured during simulated fetal surgery and strongly correlate with fetal acid/base status.

Effects of amniodistention with carbon dioxide on fetal acid-base status during fetoscopic surgery in a sheep model

2001 ◽  
Vol 15 (4) ◽  
pp. 368-372 ◽  
Author(s):  
E. Gratacós ◽  
J. Wu ◽  
R. Devlieger ◽  
M. Van de Velde ◽  
J. A. Deprest
Keyword(s):  
Carbon Dioxide ◽  
Acid Base ◽  
Sheep Model ◽  
Acid Base Status

To Manage Infantile Hypertrophic Pyloric Stenosis by "Double-Y Pyloromyotomy" is a better Surgical Approach

2014 ◽  
Vol 1 (2) ◽  
pp. 143-147
Author(s):  
Md. Ansar Ali ◽  
Kaniz Hasina ◽  
Shahnoor Islam ◽  
Md. Ashraf Ul Huq ◽  
Md. Mahbub-Ul Alam ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Treatment Modalities ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Postoperative Vomiting ◽  
Acid Base ◽  
Feeding Regimes ◽  
Acid Base Status ◽  
Postoperative Feeding

Background: Different treatment modalities and procedures have been tried for the management of infantile hypertrophic pyloric stenosis. But surgery remains the mainstay for management of IHPS. Ramstedt’s pyloromyotomy was described almost over a hundred years ago and to date remains the surgical technique of choice. An alternative and better technique is the double-Y pyloromyotomy, which offer better results for management of this common condition.Methods: A prospective comparative interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. The study was designed that all patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy(DY) and the next by aRamstedt’s Pyloromyotomy (RP). Data on patient demographics, operative time, anesthesia complications, postoperative complications including vomiting and weight gain were collected. Patients were followed up for a period of 3 months postoperatively. Statistical assessments were done by using t test.Results: From July 2008 through July 2010, fourty patients were finally analyzed for this study. Any statistical differences were observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status were recorded. Significant differences were found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups were collected. Vomiting in double-Y(DY) pyloromyotomy group (1.21 ± 0.45days) vs Ramstedt’s pyloromyotomy (RP) group(3.03 ± 0.37days) p= 0.0001.Weight gain after 1st 10 days DY vs RP is ( 298 ± 57.94 gm vs193±19.8 gm p=0.0014), after 1 month (676.67±149.84 gm vs 466.67 ± 127.71 gm, p=0.0001), after 2months (741.33± 278.74 gm vs 490±80.62 gm, p=0.002) and after 3 months (582±36.01gm vs 453.33±51.64 gm, p=0.0001).No long-term complications were reported and no re-do yloromyotomy was needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19532

The oxygen- and acid-base status during hypothermic cardiopulmonary bypass

1988 ◽  
Vol 48 ◽  
pp. 63-71 ◽  
Author(s):  
Ivar Gøthgen ◽  
Ole Siggaard-Andersen ◽  
Jens Rasmussen ◽  
Peter Wimberley ◽  
Niels Fogh. Andersen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Acid Base ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Acid Base Status
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