Pneumoperitoneum affects stroke volume variation in humans

Abstract

A pneumoperitoneum increased SVV, which is similar to the findings of previous animal studies but is different from a previous clinical study. Upon release of the pneumoperitoneum, SVV decreased significantly, which is new information. SVV values must be estimated cautiously during a pneumoperitoneum.

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

“…This reported lack of increase in SVV is questionable because in all reported animal studies (12)(13)(14)(15), SVV increased after elevation of intra-abdominal pressure and/or pneumoperitoneum. We recently found that pneumoperitoneum increased SVV in humans (6), and furthermore, many animal studies showed that other dynamic indices such as systolic pressure variation and pulse pressure variation (23,24) also increased during intra-abdominal hypertension (12)(13)(14)(15)(25)(26)(27) Our results relating to PVI and SVV after pneumoperitoneum were different than those of Høiseth et al (11) and Liu et al (3), and the reason for the discrepancy is unclear. However, we suppose this relates to differences in study design.…”

“…However, in reference to the studies of Høiseth et al (11) and Liu et al (3), we believe that the effect of pneumoperitoneum on PVI is still unclear. In our recent study, however, we found that pneumoperitoneum increased SVV (6), and this result was very similar to that of several earlier studies (12)(13)(14)(15). Høiseth et al (11) showed that SVV did not change as pneumoperitoneum was established, whereas PVI increased in their study, and furthermore, in a recent study describing the effect of pneumoperitoneum on PVI, the baseline was 5 min after endotracheal intubation (3), and we believe that this methodology is questionable for this kind of this study.…”

“…We recently reported that pneumoperitoneum increased SVV, and furthermore, upon release of the pneumoperitoneum, SVV decreased significantly (6). We have asserted that SVV values must be estimated cautiously during pneumoperitoneum (6).…”

“…We have asserted that SVV values must be estimated cautiously during pneumoperitoneum (6). Pleth variability index (PVI) is another dynamic index, and many studies concluded that it is useful for the assessment of fluid responsiveness in patients (2,(7)(8)(9) although one study concluded that PVI seems inaccurate to predict fluid responsiveness after conventional…”

The impact of intra-abdominal pressure on the stroke volume variation and plethysmographic variability index in patients undergoing laparoscopic cholecystectomy

“…By contrast, dynamic variable such as stroke volume variation (SVV) has been shown to be a good predictor of volume responsiveness in mechanically ventilated patients undergoing open chest surgery, liver transplantation, and abdominal surgery (4)(5)(6). However, it was controversial whether SVV changed when IAP was increased in patients undergoing laparoscopic surgery (7,8). On the other hand, noninvasive plethysmographic variability index (PVI) is a new parameter used for the purpose of fluid responsiveness in patients receiving several kinds of surgeries (9)(10)(11)(12)(13)(14).…”