Carbon Dioxide Absorption Is Not Linearly Related to Intraperitoneal Carbon Dioxide Insufflation Pressure in Pigs

Laparoscopic cholecystectomy using abdominal wall retraction

“…This finding is in agreement with those of others who showed that the increase of PCO 2 during laparoscopy is not linearly related to the intraabdominal pressure of CO 2 pneumoperitoneum [8]. It is suggested that recruitment of peritoneal absorption area is an important factor to determine the rate of CO 2 absorption from the peritoneal cavity [8,9]. It is conceivable that recruitment of more gas-exchange area during abdominal wall retraction may result in an increase of PCO 2 similar to the increase observed at higher intraabdominal pressures.…”

“…The use of AWR was also associated with the gradual development of respiratory acidosis. This finding is in agreement with those of others who showed that the increase of PCO 2 during laparoscopy is not linearly related to the intraabdominal pressure of CO 2 pneumoperitoneum [8]. It is suggested that recruitment of peritoneal absorption area is an important factor to determine the rate of CO 2 absorption from the peritoneal cavity [8,9].…”

“…It is conceivable that recruitment of more gas-exchange area during abdominal wall retraction may result in an increase of PCO 2 similar to the increase observed at higher intraabdominal pressures. Alveolar dead space ventilation is also an important contributor to respiratory acidosis during laparoscopy [8]. The alveolar dead space was not measured in this study.…”

Hemodynamics during laparoscopic extra- and intraperitoneal insufflation

“…Two mechanisms contribute to the development of hypercarbia during laparoscopy: absorption from the intra-or extraperitoneal cavity and increased physiologic dead space ventilation. Lister showed in an experimental study on pigs that CO 2 absorption from the abdominal cavity depends on the level of intraabdominal pressure [9]. He hypothesized that by increasing the intraabdominal pressure from 0 to 10 mmHg a progressively larger area of the peritoneum is exposed to CO 2 , resulting in an increase in the diffusion area.…”

Estudo comparativo dos efeitos hemodinâmicos e ventilatórios da ventilação controlada a volume ou a pressão, em cães submetidos ao pneumoperitônio

“…O padrão é caracterizado por uma fase inicial, com um rápido aumento na eliminação do CO 2 (27-37 mL.min -1 ) logo após o início da insuflação, seguido de uma fase mais lenta, devido a distensão da superfície peritoneal com a compressão dos vasos peritoneais 23 . Este padrão de eliminação pulmonar bifásico também foi observado em modelo animal 24 . O CO 2 apresenta boa solubilidade sangüínea gerando uma solução ácida.…”