1. Fetoscopic insufflation of heated‐humidified carbon dioxide during simulated spina bifida repair is safe under controlled anesthesia in the fetal lamb
- Author
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Luc Joyeux, David Basurto, Tom Bleeser, Lennart Van der Veeken, Simen Vergote, Yada Kunpalin, Lucas Trigo, Enrico Corno, Felix R. De Bie, Paolo De Coppi, Sebastien Ourselin, Frank Van Calenbergh, Stuart B. Hooper, Steffen Rex, and Jan Deprest
- Subjects
safety ,fetal surgery ,Hot Temperature ,Sheep ,carbon dioxide insufflation ,Fetoscopy ,myelomeningocele ,Obstetrics and Gynecology ,Humidity ,Insufflation ,fetoscopy ,Carbon Dioxide ,fetal hypercapnia ,Pregnancy ,Animals ,Anesthesia ,Female ,fetal acidosis ,Spina bifida ,Spinal Dysraphism ,Genetics (clinical) - Abstract
OBJECTIVE: To assess the safety of Partial-Amniotic-Insufflation-of-heated-humidified-CO2 (hPACI) during fetoscopic spina bifida repair (fSB-repair). METHOD: A simulated fSB-repair through an exteriorized uterus under hPACI was performed in 100-day fetal lambs (term = 145 days) under a laboratory anesthesia protocol (n = 5; group 1) which is known to induce maternal-fetal acidosis and hypercapnia. Since these may not occur clinically, we applied a clinical anesthesia protocol (n = 5; group 2), keeping maternal parameters within physiological conditions, that is, controlled maternal arterial carbon dioxide (CO2) pressure (pCO2 = 30 mmHg), blood pressure (≥67 mmHg), and temperature (37.1-39.8°C). Our superiority study used fetal pH as the primary outcome. RESULTS: Compared to group 1, controlled anesthesia normalized fetal pH (7.23 ± 0.02 vs. 7.36 ± 0.02, p
- Published
- 2022