Haemodynamic changes during low‐pressure carbon dioxide pneumoperitoneum in young children

Waal, Eric E. C. de; Kalkman, Cor J.

doi:10.1046/j.1460-9592.2003.00973.x

Cited by 51 publications

(24 citation statements)

References 33 publications

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“…Other authors have found that short-term pneumoperitoneum has minimal effects on CI when IAP is lower than 15 mm Hg. [14][15][16][17] Our study shows that changes in cardiovascular stability and acid-base balance can develop with latency when IAP is increased for several hours. This is of clinical relevance, because advanced laparoscopic surgery may be time-consuming and usually lasts longer than 60 min.…”

Section: Discussionmentioning

confidence: 62%

Haemodynamic, acid–base and blood volume changes during prolonged low pressure pneumoperitoneum in rabbits

Sümpelmann

Schürholz

Marx

et al. 2006

British Journal of Anaesthesia

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Our animal model suggests that a decrease in CI, metabolic acidosis and hypovolaemia could occur after prolonged low pressure pneumoperitoneum in small infants, which is possibly not detectable by the standard monitor setting. Therefore, the routine use of an extended monitoring including measurement of central venous oxygen saturation and acid-base parameters should be considered during and soon after operation, when pneumoperitoneum will last longer than 2 h.

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Section: Discussionmentioning

confidence: 62%

Haemodynamic, acid–base and blood volume changes during prolonged low pressure pneumoperitoneum in rabbits

Sümpelmann

Schürholz

Marx

et al. 2006

British Journal of Anaesthesia

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“…During laparoscopic fundoplication for gastroesophageal reflux performed in the head-up position (10°) and at 5 mm Hg, an increase of 22% in CI was recorded, along with a 21% increase in mean arterial pressure and a 17% increase in heart rate [9]. The results of all these above mentioned studies illustrate the hemodynamic changes depend directly on intra-abdominal pressure.…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Circulatory and Respiratory Complications of Carbon Dioxide Insufflation

Gutt¹,

Oniu

Mehrabi³

et al. 2004

Dig Surg

291

272

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Background: Although providing excellent outcome results, laparoscopy also induces particular pathophysiological changes in response to pneumoperitoneum. Knowledge of the pathophysiology of a CO₂ pneumoperitoneum can help minimize complications while profiting from the benefits of laparoscopic surgery without concerns about its safety. Methods: A review of articles on the pathophysiological changes and complications of carbon dioxide pneumoperitoneum as well as prevention and treatment of these complications was performed using the Medline database. Results: The main pathophysiological changes during CO₂ pneumoperitoneum refer to the cardiovascular system and are mainly correlated with the amount of intra-abdominal pressure in combination with the patient’s position on the operating table. These changes are well tolerated even in older and more debilitated patients, and except for a slight increase in the incidence of cardiac arrhythmias, no other significant cardiovascular complications occur. Although there are important pulmonary pathophysiological changes, hypercarbia, hypoxemia and barotraumas, they would develop rarely since effective ventilation monitoring and techniques are applied. The alteration in splanchnic perfusion is proportional with the increase in intra-abdominal pressure and duration of pneumoperitoneum. Conclusion: A moderate-to-low intra-abdominal pressure (<12 mm Hg) can help limit the extent of the pathophysiological changes since consecutive organ dysfunctions are minimal, transient and do not influence the outcome.

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“…Conventional surgery is associated to significant morbidity and laparoscopy is currently the technique of choice. It is important that anesthesiologists are aware of physiological changes associated to children's pneumoperitoneum in this type of procedure, such as increased CO 2 expired fraction, PaCO 2 , cardiac index, heart rate, blood pressure and maximum inspiratory pressure 31 . The need for intensive therapy seems to be minimized with laparoscopy.…”

Section: Anti-reflux Surgerymentioning

confidence: 99%

Anestesia e paralisia cerebral

Maranhão¹

2005

Rev. Bras. Anestesiol.

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Anesthesiologists play an important role in decreasing anesthetic-surgical morbidity and mortality of cerebral palsy patients. The understanding of different aspects of cerebral palsy pathophysiologies, in addition to those of associated diseases and their therapies is paramount, because it allows anesthesiologists to anticipate and prevent intra and postoperative complications in this type of patient.

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Haemodynamic changes during low‐pressure carbon dioxide pneumoperitoneum in young children

Abstract: We conclude that low-pressure CO2 pneumoperitoneum (with IAPs not exceeding 5 mmHg) for laparoscopic fundoplication in infants and children does not decrease their cardiac index.

Cited by 51 publications

References 33 publications

Haemodynamic, acid–base and blood volume changes during prolonged low pressure pneumoperitoneum in rabbits

Haemodynamic, acid–base and blood volume changes during prolonged low pressure pneumoperitoneum in rabbits

Circulatory and Respiratory Complications of Carbon Dioxide Insufflation

Anestesia e paralisia cerebral

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