The Effects of Increased Abdominal Pressure on Lung and Chest Wall Mechanics During Laparoscopic Surgery

Comparison of pressure and volume‐controlled ventilation in laparoscopic cholecystectomy operations

“…Accordingly, compliance decreased after pneumoperitoneum in both two groups, but in the group P at a higher level. Atelectasis of the lower zones may be shown as the cause of this reduction in compliance . If compliance did not normalize after removal of the CO 2 , it may suggest that atelectasis still continued.…”

Comparison of Thoracic and Abdominal Cavity Volumes During Abdominal CO2 Insufflation and Abdominal Wall Lift

“…Increased heart rate, systemic vascular resistance, decreased cardiac output, and increased arterial and central venous pressures have been reported in people with CO 2 insufflation laparoscopy . Additionally, lung and chest wall impedances to mechanical ventilation increase with increasing intraperitoneal pressures during laparoscopy . In healthy patients, these changes are reversible once capnoperitoneum is relieved.…”

Post‐extubation continuous positive airway pressure improves oxygenation after pediatric laparoscopic surgery: A randomized controlled trial

“…Spadaro et al have investigated the effect of three different levels of PEEP (0, 5, and 10 cmH 2 O) in adult patients undergoing either laparotomy or laparoscopic surgeries using intraoperative shunt levels and dynamic compliance as assessment parameters . They concluded that a more aggressive PEEP level is required to reduce shunt and to normalize respiratory compliance during laparoscopic surgery because of the reduction of FRC caused by the pneumoperitoneum . Acosta et al suggested that PEEP levels higher than the usual 5 cmH 2 O would be required to preserve normal lung aeration during pneumoperitoneum in pediatric laparoscopic surgeries .…”

“…Atelectasis and poorly ventilated lung areas are negative consequences of general anesthesia observed in adults as well as in children secondary to the reduction of the end‐expiratory lung volume (FRC) and the resultant airway closure, consequently leading to decreased lung compliance, impairment of oxygenation, increased pulmonary vascular resistance, and development of lung injury . Laparoscopic surgery with associated pneumoperitoneum further worsens respiratory mechanics accentuating atelectasis formation . Studies show a strong correlation between the development of atelectasis and postoperative pulmonary complications (PPCs)…”