SOPRO COMEG SYMBIOZ Flow Manual De Usuario página 13

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sAFeTY insTRUCTiOns
Additional multiple-socket outlets or extension cords must not be connected to the EM system.
It is advisable to have a second insufflator in the operating theatre so that action can be
taken if the device fails to perform or if a deterioration in performance is noticed.
The use of this device is always contraindicated in cases of intra-abdominal distension, or
when laparoscopy is contraindicated. Kindly refer to our laparoscope user manual for absolute
and relative contraindications.
This instrument is contraindicated for hysteroscopic insufflation; it should never be used in
cases of intrauterine distension.
Note: the insufflator distension pressure for laparoscopy must never exceed 25 mm Hg.
WARNINGS
Metabolic acidosis and cardiac rhythm disorders
Avoid prolonging intra-abdominal pressure beyond 20 mm of mercury. This could lead to the
following risks:
• Restricted breathing and compromised diaphragmatic movement which can lead to acidosis
• Decreased venous return
• Decreased heart rate
Excessive absorption of CO2 is due either to an excessively high flow rate, or excessive pres-
sure, or both. The abdomen can be adequately distended with a pressure of between 10 and
15 mm of mercury. It is seldom necessary to work below abdominal pressures above 15 mm of
mercury. At these levels, the extent of intravasation is low. Pressures above 20 mm of mercury
are very seldom needed; they will increase the quantity and speed of intravasation. Adequate
respiration helps prevent problems associated with CO2.
Idiosyncratic reactions
In the case of patients suffering from micro-sickle-cell diseases or pulmonary insufficiency, the
use of these machines can increase the risk of metabolic imbalance linked to excessive absorp-
tion of CO2.
Hypothermia
High-flow-rate insufflators lead to potential risk of hypothermia; we therefore recommend using
a heating system so that the patient's temperature remains stable.
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