Users Manual
General Information
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WARNING!
Haemodynamic stability
A laparoscopy performed on children younger than 12 years of age may result in
problems of the haemodynamic system due to the CO
2
content in the blood. It is re-
commended to increase the breathing rate of the patient and to work with low
flow values and pressure values not exceeding 12mmHg. The patient's circulatory
system should be monitored at all times.
WARNING!
Hypothermia
The insufflation gas flow usually drops significantly after the target pressure has
been reached and it is then only required to maintain the abdominal pressure.
However, leaks within the abdomen or the instrument can lead to a constant gas
flow of above 1 l/min. When operating on children younger than 12, a gas flow of
more than 1 l/min poses an increased risk of hypothermia for the patient. Corres-
ponding measures to prevent hypothermia include the use of blankets or pre-
warmed gas. The patient's body temperature has to be monitored at all times dur-
ing surgery.
WARNING!
Children with cardiovascular problems
Laparoscopy with CO
2
should not be performed on children with cardiovascular
problems.
WARNING!
Hypercapnia
Because pediatric patients are especially susceptible to hypercapnia, it is recom-
mended to establish an end-tidal CO
2
monitoring routine.
3.3.4 Warnings Vessel Harvest Operating Mode
WARNING!
CO
2
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 CO
2
is always ab-
sorbed through the tissue of the patient during insufflation (intravasation). This
means the body absorbs part of the CO
2
gas used for insufflation. CO
2
concentra-
tions 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 pa-
tient is breathing well. Sufficient respiration can help avoid or limit problems with
CO
2
. High pressure or a high gas flow promotes CO
2
absorption.
WARNING!
Metabolic and cardiac reactions
Insufflating CO
2
may result in metabolic acidosis. This can lead to cardiac irregular-
ities expressed with the following symptoms:
• Reduced respiration with restricted diaphram function
• Hypercapnia
• Reduction of venous reflux
• Reduced cardiac output
• Metabolic acidosis
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DRAFT