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Endosc Ultrasound. 2019 Jun 20. doi: 10.4103/eus.eus_32_19. [Epub ahead of print]

Transcutaneous partial pressure of carbon dioxide monitoring during EUS-guided drainage of peripancreatic fluid collections using carbon dioxide insufflation: A prospective study.

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Endoscopy Center, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province, China.



Carbon dioxide (CO2) insufflation has become more commonly used in EUS-guided interventions in recent years. However, there is a paucity of information regarding methods by which to monitor in vivo CO2 levels. This study aimed to assess the feasibility of a novel noninvasive method to monitor transcutaneous partial pressure of CO2 [INSIDE:1] levels during EUS-guided drainage of peripancreatic fluid collections (PFCs). The safety of CO2 insufflation in EUS-guided interventions was also investigated.

Patients and Methods:

Patients who underwent EUS-guided PFC drainage between September 2015 and December 2016 at Shengjing Hospital of China Medical University were prospectively enrolled in this study. [INSIDE:2] was measured in all patients using a noninvasive sensor throughout the procedure.


There were 25 patients eligible to be included in this study. The mean procedure time was 53.1 min. The mean [INSIDE:2] level was 40 ± 4 mmHg and 48 ± 5 mmHg before and after the procedure, respectively. The mean peak [INSIDE:2] during the procedure was significantly higher at 53 ± 6 mmHg (P < 0.0001). No complications associated with CO2 insufflation such as CO2 narcosis, gas embolism, or arrhythmias were encountered.


[INSIDE:2] monitoring can accurately reflect the level of [INSIDE:3] continuously and noninvasively. CO2 insufflation is safe for patients undergoing relatively complicated EUS-guided drainage of PFCs.


Carbon dioxide; EUS; peripancreatic fluid collections; transcutaneous partial pressure of carbon dioxide monitoring


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