Despite prompt normalization of circulation and oxygenation after surgery, recovery of rSat of the brain took 6-26 h, probably because of higher energy demand after CPB. Pre-operative cerebral oxygenation may be underestimated as a possible cause of adverse post-operative outcome.
Peritoneal CO(2) absorption during laparoscopic surgery causes hypercapnia and CO(2)-mediated cerebral hemodynamic effects. Hyperventilation and the head-up position before CO(2) insufflation is not sufficient to counteract these effects of low-pressure pneumoperitoneum (5--8 mm Hg) in children.
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