Aesculap Flow 50 Instrucciones De Manejo página 119

Indications of the Flow 50 Insufflator
WARNING!
Subcutaneous emphysema
Incorrect placement of a cannula or a trocar into subcutaneous tissue may lead
to emphysema. To reduce the risk, use a low gas flow rate for the first insuffla-
tion and ensure that the insufflation instrument is correctly positioned. Long sur-
geries, the use of many access points, duration and size of leaks at these points
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may also contribute to emphysema. Be sure to close leakages in trocar accesses
immediately.
WARNING!
Additional insufflation sources/automatic venting system
Make sure the automatic venting system is activated (see chapter 7 Menu). The
use of additional insufflation sources increases the intra-abdominal pressure.
Continuously monitor intra-abdominal pressure over the course of the entire in-
sufflation if additional sources are used.
WARNING!
Altered Respiratory Physiology
Always monitor the patient's respiratory functions during the entire surgery. The
larger body mass supported by the thoracic cage and the larger amount of fat in
the abdominal cavity may reduce the elasticity of the thoracic wall. In addition,
the increased intra-abdominal pressure secondary to insufflation may alter the
normal physiological lung parameters thus resulting in a reduction of the func-
tional lung volume. Shallow, rapid breathing is symptomatic of this condition.
Even modest physical stress causes a tremendous increased demand for oxygen,
which stands in contrast to the ineffective respiratory musculature that requires
more oxygen because it must overcome the reduced elasticity of the thoracic
cage. The functional capacity of the lungs is small and even moderate stress can
lead to respiratory failure.
WARNING!
Subcutaneous emphysema
When puncturing the thicker abdominal wall of morbidly obese patients with
the Veress cannula or the trocar, carefully monitor the correct position of the in-
strument in the abdomen.
WARNING!
CO supersaturation
2
To avoid generating CO supersaturation, an increased level of respiratory activ-
2
ity is required. An overweight patient's oxygen demand and carbon dioxide pro-
duction are greater and increase faster under physical stress than do those of
patients with normal body weight.
WARNING!
Heart and cardiovascular insufficiency
Constantly monitor all heart and cardiovascular parameters during surgery since
morbidly obese patients have an increased risk of heart and cardiovascular insuf-
ficiencies.
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