Absorption of carbon dioxide during laparoscopy in children measured using a novel mass spectrometric technique

M. Pacilli, Agostino Pierro, C. Kingsley, Joseph I. Curry, Jane Herod, S. Eaton

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Background. Carbon dioxide (CO2) is absorbed during pneumoperitoneum and may cause adverse haemodynamic effects. The aim of this study was to measure the elimination of exogenous CO2 during laparoscopy in children. Methods. Ten children [27.6 (56.5) months; mean (sd)] undergoing laparoscopic and nine [24.5 (17.3) months] undergoing open surgery were studied. Breath samples were collected at the line for end-tidal CO2 and analysed for 13CO2/ 12CO2 ratio expressed as δPDB (difference from standard), by isotope-ratio mass spectrometry. The proportion of absorbed CO2 was calculated comparing exhaled 13CO2/12CO2 before and during CO2 pneumoperitoneum. Results. 13CO2/12CO2 in medical CO2 was -32.7 (2.1) δPDB. 13 CO2/12CO2 in breath of patients undergoing open procedures was -24.3 (2.4) δPDB at the start of operation and did not change during the operation (P>0.2). 13CO2/12CO2 in breath of patients undergoing laparoscopy was -21.5 (5.4) δPDB at the start of insufflation, and decreased during pneumoperitoneum by 2.5 (1.6) δPDB, indicating absorption of exogenous CO2. The percentage of expired CO2 absorbed rose to 15.5 (7.7)% after 30 min of pneumoperitoneum and decreased rapidly after desufflation. Conclusion. After 10 min of laparoscopy 10-20% of expired CO2 derives from the exogenous CO2. CO2 absorption can be measured using a simple mass spectrometric technique.

Original languageEnglish
Pages (from-to)215-219
Number of pages5
JournalBritish Journal of Anaesthesia
Issue number2
Publication statusPublished - Aug 2006
Externally publishedYes


  • Carbon dioxide, absorption
  • Pneumoperitoneum
  • Procedure, mass spectrometry
  • Surgery, laparoscopy

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