Alterações hemodinâmicas durante o pneumoperitônio em cães ventilados com volume e pressão controlados

Abstract

RESUMO C O N C L U S Õ E S : A s m o d a l i d a d e s v e n t i l a t ó r i a s n ã o BACKGROUND AND OBJECTIVES: There are no studies associating ventilation-induced effects and hemodynamic changes during pneumoperitoneum. This study aimed at evalua t i n g h e m o d y n a m i c c h a n g e s d e t e r m i n e d b y pneumoperitoneum in dogs under

Efeitos do pneumoperitônio sobre a hemodinâmica e função renais de cães ventilados com volume e pressão controlados

“…Mechanical ventilation, for determining intra-thoracic pressure increase and, as a consequence, decreased venous return and cardiac output, may stimulate vasopressin release and atrial natriuretic factor inhibition. Our study, however, has not observed cardiac index decrease 26 or changes in plasma vasopressin values for both groups. Vasopressin, which plays a major role in renal perfusion and water reabsorption has not changed in our study, and IAP has not exceeded 15 mmHg for one hour.…”

“…In favorable hemodynamic conditions there is increase in renal blood flow, renal plasma flow and filtration fraction with increased cardiac output and decreased peripheral resistance; in fact, there is a decrease in filtration fraction, that is, the rate between glomerular filtration rate and renal plasma flow, showing that increased renal plasma flow was proportionally higher that glomerular filtration rate 25 . So, filtration fraction decrease observed in our study, where there has been cardiac index increase and systemic vascular resistance decrease 26 , would be a consequence of increased renal plasma flow. In extracellular fluids, sodium cation and the two major anions following it, chloride and bicarbonate, are responsible for 90% solutes in this compartment 25 .…”

“…Cardiac output and blood pressure decrease leads to renal blood flow decrease, rennin-angiotensin-aldosterone system activation and higher sodium and water absorption, changing plasma osmolality. Our study has not observed cardiac index, mean blood pressure 26 and renal blood flow changes in both groups, thus not expecting influences in plasma osmolality, which has remained stable throughout the procedure and was not influenced by pneumoperitoneum, hydration or mechanical ventilation. Most remarkable event triggered by IAP increase on kidneys is diuresis decrease 1,8,17,19,30 .…”

“…So, trends to sodium clearance and urinary and fractional excretion decrease could reveal mild renal function involvement triggered by IAP increase, leading to parenchymal compression and promoting possible changes in tubular absorption and secretion. Higher values for these attributes in Group 1 could be a reflex of higher mean blood pressure values observed in G1 25,26 . As to potassium, it is believed that almost everything that is filtered is reabsorbed and that potassium excreted by the urine is originated from tubular secretion.…”

Changes in Acute Phase Proteins in Bitches after Laparoscopic, Midline, and Flank Ovariectomy Using the Same Method for Hemostasis

“…Laparoscopic procedures also have some disadvantages over open conventional procedures: high cost of the equipment, the need of an assistant, higher learning curve, longer surgical time, and the requirement of intra-abdominal carbon-dioxide (CO 2 ) insufflation (pneumoperitoneum) [43,[46][47][48]. The latter has been associated with several complications, which include visceral pain, local peritonitis, hemodynamic changes, oxidative stress, and inflammation [49][50][51][52][53].…”