Stryker PneumoSure Gebrauchsanleitung Seite 19

Device Purpose
reaction).
EN
WARNING!
CO2 absorption
Due to the special surgical procedures - start of the heart bypass operation, and
the endoscopic removal of the vessel - special care has to be taken as CO2 is al-
ways absorbed through the tissue of the patient during insufflation (intravasa-
tion). This means the body absorbs part of the CO2 gas used for insufflation. CO2
concentrations in the blood or respiratory system that are too high can lead to
death of the patient in extreme cases. To lower this risk, always carefully and
closely monitor the patient's vital signs during the entire insufflation process
and make sure patient is breathing well. Sufficient respiration can help avoid or
limit problems with CO2. High pressure or a high gas flow promotes CO2 absorp-
tion.
WARNING!
Metabolic and cardiac reactions
Due to the special surgical conditions - start of the heart bypass surgery and ves-
sel harvesting - it is especially important to remember the existing risk of meta-
bolic acidosis when insufflating with CO2. This can lead to cardiac irregularities
expressed with the following symptoms:
• Reduced respiration with restricted diaphram function
• Hypercapnia
• Reduction of venous reflux
• Reduced cardiac output
• Metabolic acidosis
WARNING!
Dehydration
Insufflation can lead to dehydration of the tissue. This can result in organ tissue
damage and cardiovascular reactions of the patient. Long surgeries and large
leaks increase the risk of dehydration (especially at the insertion points of the
trocars or when changing instruments).
WARNING!
Embolism
Improper placement of the insufflation instrument could cause insufflation of
gas into a vessel, resulting in air or CO2 embolisms. To reduce the risk of air or
CO2 embolism, perform initial insufflation at a low flow rate and ensure that the
insufflation instrument is correctly positioned. Check the position of the insuf-
flation instrument immediately if the actual pressure rapidly reaches the nomi-
nal pressure value. CO2 embolisms can also be caused by a high pressure. Avoid
high-pressure settings and close damaged blood vessels at once.
WARNING!
Only specially trained and qualified personnel may use this device on children or
for the endoscopic vessel harvesting procedure.
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