Improving the adverse changes in cardiac autonomic nervous control during laparoscopic surgery, using an intermittent sequential pneumatic compression device

Overcoming Reduced Hepatic and Renal Perfusion Caused by Positive-Pressure Pneumoperitoneum

“…35 The second applied the ISPC device to improve cardiovascular performance and to affect cardiac autonomic nervous system control during PPP. 29,30,40 Its use is feasible, it is not associated with the drawbacks already mentioned, and its underlying mechanism can be reasonably explained.…”

“…5,[13][14][15][16]43 Because the measurements in each of the patients were paired and other factors remained unchanged, it is reasonable to conclude that the improvement in hepatic flow was attributable to the hemodynamic and autonomic effects of ISPC. 30,40 Nevertheless, further investigations are needed to determine whether hemodynamic improvement may reverse the metabolic and immunological changes associated with PPP. [10][11][12] Renal blood flow, tubular functions, and glomerular filtration rate are affected by numerous multifactorial and complex mechanisms resulting in decreased urine out-put.…”

Systematic review of oxidative stress associated with pneumoperitoneum

“…This device compresses the lower limb veins, using two sleeves wrapped around the patient's legs from ankle to groin. This has been shown to reduce venous stasis and deep venous thrombosis88–92, to improve haemodynamic parameters during operation87, 93, 94 and to reduce plasma levels of total lipid peroxides during the reperfusion phase in laparoscopic cholecystectomy95, 96. Peroneal nerve compression has been reported as a rare complication of this system of lower leg compression97, 98.…”

Power spectral analysis of heart rate variability during helium pneumoperitoneum: The mechanism of increased cardiac sympathetic activity and its clinical significance

“…Cardiac output was not measured in our study due to technical reasons. Recently, improved autonomic control was achieved, partly due to hemodynamic manipulations [3]. Apart from the wellknown advantages associated with using helium gas for PP (in addition to those proved by our study), the main disadvantage associated with its use should not be forgotten [6,9,11,23].…”