Power spectral analysis of heart rate variability during positive pressure pneumoperitoneum

Abstract

Increased LF power reflects sympathetic cardiac activation. As the LF range accounts for regulation of blood pressure and baroreflex, several mechanisms may explain this activation. This in turn may predispose patients who suffer from cardiac disease to higher risk of developing ventricular arrhythmias, besides the possible adverse hemodynamic consequences of PPP.

Immunologic parameters during NOTES compared with laparoscopy in a randomized blinded porcine trial

“…The authors encountered the opposite finding in declining postoperative TNF-a titers. While we were able to detect cytokine levels in all analyzed specimens, we did not have unexpected major complications in the control group and utilized a randomized design, many confounding variables still persist: the abdominal pressure of both experimental groups was significantly different, a factor known to influence the operative trauma [13]. The choice of insufflation gas is known to affect the immune reaction during laparoscopy with CO 2 , providing a protective effect [14,15].…”

Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis

“…In addition, hormonal changes centrally and peripherally coordinated lead to greater releases of renin, angiotensin and vasopressin, which act together during episodes of increased intraperitoneal pressure and affect renal activity 9 . Positive intraperitoneal pressures also cause increases in sympathetic activity regulated by baroreceptors and mediated by the effects of hypercapnia, which may lead to renal cortical vasoconstriction and its sequelae 10,11 . Changes in renal blood flow within the cortex and the renal medulla promote the changes discussed above 6,[11][12][13] .…”

“…This fact is exacerbated by the compression of vessels of the portal system, which further reduces the blood supply to liver cells 18 . Changes in liver blood flow are also associated with the sympathetic and humoral systems, triggered by hypercapnia and by increased intraperitoneal pressure 10 . The use of anesthetic drugs reduces cardiac output and blood supply to the liver 19 .…”

Cardiovascular autonomic function in patients with hemodynamic instability at induction of capnoperitoneum: a case–control study

“…Previous work with heart rate variability analysis has shown that the bradycardia seen immediately after carbon dioxide insufflation of the abdomen is vagally mediated [5]. This is followed by an increase in the sympathetic tone [3,17], which seems to be directly correlated with the degree of intraabdominal pressure [2,18]. The precedence of parasympathetic over sympathetic effect on the heart rate at induction of PPCpn may be attributable to a more rapid response of the heart rate to parasympathetic stimulation than to sympathetic stimuli [13].…”