CO2 in surgery

CO2 Abdominal Insufflation Decreases Local and Systemic Inflammatory Response in Experimental Acute Pancreatitis

Marcel Cerqueira Cesar Machado, MD, PhD et al

Pancreas Journal 2009

"The main causes of morbidity and mortality after pancreatic

surgery are related to Acute Pancreatitis with consequent pancreatic fistula and

systemic inflammation. Our data demonstrated that CO2 abdominal

insufflation attenuates systemic inflammatory response

in Acute Pancreatitis with a reduction of proinflammatory cytokines TNF-> and

IL-6 without a significant change in serum IL-10. It also reduces

the inflammation both in the pancreas and in the peritoneal

cavity. This article suggests that CO2 pneumoperitoneum plays

a critical role on the better outcome in patients undergoing

laparoscopic pancreatic surgery."

CO2 abdominal insufflation pretreatment increases survival after a lipopolysaccharide-contaminated laparotomy"

Joseph M Fuentes et al

Journal of Gastrointestinal Surgery. January 2006.

"Carbon dioxide (CO(2))-pneumoperitoneum is known to favorably modify the systemic immune response during laparoscopic surgery. The presented studies were designed to determine whether treating animals with CO(2) abdominal insufflation before undergoing a lipopolysaccharide (LPS)-contaminated laparotomy would serve as "shock prophylaxis" and thus improve survival and attenuate cytokine production. Rats were randomized into five groups: CO(2)-pneumoperitoneum, helium-pneumoperitoneum, anesthesia control, laparotomy/LPS control, and LPS only control. Animals in the first four groups all received a laparotomy and a lethal dose of LPS. Immediately preceding their laparotomy, animals in the pneumoperitoneum groups received a 30-minute pretreatment of abdominal insufflation with either CO(2) or helium. The anesthesia control group received a 30-minute pretreatment of isoflurane. Animal mortality was then recorded during the ensuing 72 hours. Subsequently, a similar protocol was repeated for measurements of cytokines. CO(2)-pneumoperitoneum increased survival at 48 hours compared with LPS control (P <.05), and decreased interleukin-6 plasma levels at 2 hours (P <.05). Abdominal insufflation with CO(2) before the performance of a laparotomy contaminated with endotoxin increases survival and attenuates interleukin-6. The beneficial immune-modulating effects of CO(2)-pneumoperitoneum endure after abdominal insufflation. CO(2)-pneumoperitoneum pretreatment may improve outcomes among patients undergoing gastrointestinal surgery who are at high risk for abdominal fecal contamination.

Inhaled CO2 to Reduce Lung Ischemia and Reperfusion Injuries: Moving Towards Clinical

Translation?

Claire H. Masterson, PhD1,2

Daniel O’Toole, PhD1,2

John G. Laffey, MD, MA, BSc, FCAI1,2,3

RECEIVED FROM:

1 Anaesthesia, School of Medicine, National University of Ireland, Galway, Ireland.

2 Regenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices,

Biomedical Sciences Building, National University of Ireland Galway, Galway, Ireland.

3 Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland.

American Thoracic Society 2021

"This study demonstrates a clear benefit of inspired CO2 in a ligated pulmonary artery model, although the intervention is at an early timepoint. It adds to a growing body of work accumulated to this point demonstrating the therapeutic potential of inspired CO2 for ischemia/reperfusion injuries. This possible therapeutic option is

relatively simple to implement and test, has few obvious side-effects and critical care physicians are very familiar with managing hypercapnia in the critically ill patients."

Effect of repeated subcutaneous injections of carbon dioxide on inflammation linked to hypoxia in adipose tissue graft.

G.NISI et al

European Review for Medical and Pharmacological Sciences. 2015.

"CO2 Injection enhances the inflammatory response of the implanted tissue and reduces the reabsorption rate. The treatment may improve the graft survival in a more prolonged time-frame"

Humidified Warmed CO2 Treatment Therapy Strategies Can Save Lives With Mitigation and Suppression of SARS-CoV-2 Infection: An Evidence Review

Alaa M. M. El-Betany 1*, Enas M. Behiry 2, Mark Gumbleton1* and Keith G. Harding3*

1 School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom, 2 School of Medicine, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom, 3 Wound Healing Research Unit, Welsh Wound

Innovation Centre, School of Medicine, Cardiff University, Cardiff, United Kingdom

Frontiers in Medicine 2020

"The physical, biological, and medical properties of CO2 gas suggest that humified warmed

CO2 gas possesses multiple bioactivities and offer a new concept to SARS-CoV-2 viral disinfection and COVID-19 treatment. This inexpensive and broadly applicable therapy could lead to a massive reduction in the global number of infected, especially when used as a carrier for delivery of other inhaled drugs and creates new possibilities for mitigation and suppression of any COVID-19 second wave, or indeed any new future respiratory viral pandemic. In the future, more bioactive properties of CO2 could be identified, and their mechanisms of action investigated. We believe well-designed clinical trials of CO2 and

its various bioactive properties are warranted to examine its efficacy against these diseases in human beings"