Compositions – Gaseous compositions
Reexamination Certificate
2001-08-02
2004-01-13
Silverman, Stanley S. (Department: 1754)
Compositions
Gaseous compositions
Reexamination Certificate
active
06676855
ABSTRACT:
TECHNICAL FIELD
This invention is directed at negating or reducing decrease in blood-flow to abdominal organs which would otherwise have decreased oxygen delivery because of being contacted with an insufflating gas, typically carbon dioxide.
BACKGROUND OF THE INVENTION
In laparoscopic surgery or diagnosis, the insufflating gas used normally is carbon dioxide. However, the carbon dioxide pneumoperitoneum decreases blood-flow to abdominal organs, and this can result in elevated liver functions, decreased renal perfusion, hypercapneic acidosis (due to failure to remove acid from tissue because of abnormal blood-flow), and in the case of the pregnant female, impairment of blood-flow to fetus and severe hypoxemia in fetus.
SUMMARY OF THE INVENTION
One embodiment herein, denoted the first embodiment, is directed to a method for negating or reducing decrease in blood-flow and/or hypoxemia in an abdominal organ which would otherwise have decreased oxygen delivery because of decreased blood-flow therein because of insufflating gas being delivered into the abdominal cavity, comprising contacting said abdominal organ with a blood-flow to abdominal organ decrease preventing agent in a therapeutically effective amount, preferably comprising delivering the blood-flow to abdominal organ decrease preventing agent into the abdominal cavity as part of a gas consisting essentially of the blood-flow to abdominal organ decrease preventing agent in a therapeutically effective amount and an insufflating gas. The blood-flow to abdominal organ decrease preventing agent is preferably ethyl nitrite. The insufflating gas is a blood-flow decrease and hypoxemia causing insufflating gas and is typically carbon dioxide. Very preferably, the gas consisting essentially of blood-flow to abdominal organ decrease preventing agent and insufflating gas contains from 1 to 1,000 ppm ethyl nitrite, e.g., 50 to 200 ppm ethyl nitrite. Gas insufflation into the peritoneum also impairs fetal blood flow and ethyl nitrite or other vasoditating gas can diffuse into the blood to improve fetal blood flow and hypoxemia.
Pneumoperitoneum also impairs pulmonary function and raises blood pressure and ethyl nitrite has been shown to improve pulmonary function and can lower blood pressure.
The invention of the first embodiment involves a way to prevent or reverse with a drug a complication of a laparoscopic procedure and is analogous to giving a patient a drug to raise blood pressure if blood pressure drops during surgery. The invention of the first embodiment treats a complication of laparoscopic surgery or diagnosis.
The invention of the first embodiment involves the treatment of mammals, including humans.
Another embodiment herein, denoted the second embodiment, is directed to a gas consisting essentially of insufflating gas and a blood-flow to abdominal organ decrease preventing agent in a therapeutically effective amount, e.g., ethyl nitrite used in amount of 1 to 1,000 ppm, e.g., 50 to 200 ppm.
The term “abdominal organ” is used herein to mean an organ in the abdominal cavity or retroperitoneum or a fetus or placenta.
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The Merck Manual of Diagnosis and Therapy, 16th edition, pp. 742-743 (1992).
Duke University
Medina Maribel
Silverman Stanley S.
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