Influence of pneumoperitoneum and patient positioning on respiratory system compliance

Rauh, R. D.; Hemmerling, Thomas M.; Rist, Max; Jacobi, Klaus

doi:10.1016/s0952-8180(01)00286-0

Cited by 142 publications

(119 citation statements)

References 11 publications

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“…Unquestionably, video-assisted surgery has contributed to the advancement of all medical specialties in which this technique has been put into practice. (8) The use of such procedure has rapidly expanded because of its advantages over conventional procedures. In view of this, it was expected that the proportional evolution of this minimally invasive procedure would have the positive effect of reducing the incidence of surgical complications.…”

Section: Discussionmentioning

confidence: 99%

Repercussões do pneumoperitônio na amplitude da excursão diafragmática em suínos

Normando¹,

Brito²,

Júnior³

et al. 2006

J. bras. pneumol.

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Objective: To study the effects that pneumoperitoneum achieved through carbon dioxide insufflation has on diaphragmatic excursion in pigs. Methods: A total of 14 male Landrace pigs, 30 to 45 days of age and weighing five to seven kilograms each, were used. The sample was randomly and equally divided into two groups: one (n = 7) in which pneumoperitoneum was maintained at 10 mmHg for 60 minutes; and another (n = 7) in which pneumoperitoneum was maintained at 15 mmHg (also for 60 minutes). After anesthetic induction, the animals were intubated. Flow volume was monitored, and the amplitude of diaphragmatic excursion was analyzed using noninvasive ultrasound imaging of the right hemidiaphragm. Results: In both groups, restricted diaphragmatic excursion was observed only during the procedure. There was no statistical difference between the two pressure levels studied. Conclusion: The amplitude of diaphragmatic excursion was restricted during abdominal insufflation, independent of the pressure level (within the 10-15 mmHg range), during the study period.

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Section: Discussionmentioning

confidence: 99%

Repercussões do pneumoperitônio na amplitude da excursão diafragmática em suínos

Normando¹,

Brito²,

Júnior³

et al. 2006

J. bras. pneumol.

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“…18,20 Pneumoperitoneum with position change during laparoscopic surgery has been reported to induce an increase in peak inspiratory pressure and a decrease in the distance between the TT and the carina. [21][22][23] In the present study, cephalic displacement of the TT tip was observed without endobronchial intubation. The TT tip may have moved towards the head due to splinting or distension of the diaphragm, 24 or tracheal shortening.…”

Section: Discussionmentioning

confidence: 67%

Changes in cuff pressure and position of cylindrical-cuff and tapered-cuff tracheal tubes during laparoscopic abdominal surgery

et al. 2015

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Objectives: To evaluate changes in cuff pressure and position of tapered-cuff and cylindrical-cuff tracheal tubes (TTs) during laparoscopic cholecystectomy; to compare the frequency of endobronchial intubation and airway complaints with the two types of TT. Methods: Patients were randomly assigned to intubation with a TT with a cylindrical cuff (group C) or a tapered cuff (group T). Anaesthesia was maintained with sevoflurane, O 2 and N 2 O after intubation. TT cuffs were inflated to 20 cm H 2 O; changes in cuff pressure and volume were measured up to 30 min after the start of N 2 O use. Distance between the TT tip and the carina was measured before and after pneumoperitoneum and position change. Frequency of sore throat, dysphagia and hoarseness in the two groups was recorded. Results: Cuff volume and pressure were significantly lower in group T than in group C (n ¼ 32 per group). Cuff pressure and volume significantly increased 30 min after start of N 2 O use in both groups. Distance from the TT tip to the carina decreased during surgery in both groups. There were no cases of endobronchial intubation, and there were no between-group differences in the frequency of airway complaints. Conclusions: The tapered cuff was associated with a smaller change in cuff pressure during laparoscopic cholecystectomy than the cylindrical cuff, and therefore may be associated with increased preservation of tracheal mucosal perfusion.

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“…This may worsen the risk for developing hypoxemia in patients of chronic obstructive pulmonary disease (COPD). [22,23] The anesthesiologist usually attempts to avoid hypercapnia and acidosis by increasing the tidal volume or by using positive end-expiratory pressure (PEEP), however, overuse of these maneuvers can cause ventilator-induced lung injury or further reduction of cardiac output, respectively. The routine use of other gases like argon, helium, etc., is still under study.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Low Pressure Pneumoperitoneum for Laparoscopic Cholecystectomy: A Prospective, Randomized, Triple-Blinded Trial

Nitin¹,

Sharma²,

Gupta³

et al. 2017

JGPLD

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Influence of pneumoperitoneum and patient positioning on respiratory system compliance

Cited by 142 publications

References 11 publications

Repercussões do pneumoperitônio na amplitude da excursão diafragmática em suínos

Repercussões do pneumoperitônio na amplitude da excursão diafragmática em suínos

Changes in cuff pressure and position of cylindrical-cuff and tapered-cuff tracheal tubes during laparoscopic abdominal surgery

Feasibility and Safety of Low Pressure Pneumoperitoneum for Laparoscopic Cholecystectomy: A Prospective, Randomized, Triple-Blinded Trial

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