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3. INTRODUCTION
General Warnings and Cautions - Introduction of CO
2
• Air Embolism Hazard: air should be purged from the administration set tubing
and instruments with 0.2 litres of CO
2
prior to introduction of the catheter and
gas to the patient.
• Irritation Hazard: infusion of CO
2
can result in carbonic acid irritation to tissues
that come into direct contact with the CO
2
.
• System operators should always instruct the patient to notify them should they
feel any pain during the procedure.
• In rare circumstances accidental intravasation of CO
2
occur and can result in
embolisation.
• In cases of emergency the operator should terminate gas flow by disconnecting
the administration set from the gas output port.
• Prolonged intra-colon pressures greater than 25 mm Hg should be avoided as
this can cause patient discomfort.
• Excessive absorption of CO
2
may result from an excessive flow rate and/or
excessive pressure. The colon can be adequately distended by pressure in the
range of 20-30 mm Hg. Use of pressure ≤ 25 mm Hg will dramatically reduce the
likelihood of intravasation of CO
2
gas.
• Idiosyncratic reactions: patients with sickle cell disease or pulmonary
insufficiency may be at increased risk of metabolic imbalance in relation to
excessive CO
2
absorption.