Document Detail

Cardiorespiratory effects of laparoscopy with and without gas insufflation.
MedLine Citation:
PMID:  7661685     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients who are undergoing laparoscopic procedures can present with a number of ventilatory and circulatory problems. The use of a gasless technique for performing a laparoscopy by using a mechanical lifting device may potentially avoid such problems. OBJECTIVE: To compare the cardiorespiratory effects of laparoscopy with and without gas insufflation. METHODS: Twelve adult pigs were randomized to undergo a laparoscopy by using either carbon dioxide insufflation or mechanical elevation. Full invasive monitoring was performed preoperatively and at 10-minute intervals throughout the operative period. Parameters that were measured included blood gas determinations, mean arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac output, stroke volume, and total peripheral resistance. RESULTS: Carbon dioxide insufflation unlike mechanical elevation led to a fall in PO2 and absorption of a significant quantity of CO2, resulting in hypercapnia, acidosis, and a consequent hyperdynamic circulation. CONCLUSION: These findings have significant implications for the use of CO2 insufflation for laparoscopy in patients with a compromised respiratory or cardiac status.
J P McDermott; M C Regan; R Page; M A Stokes; K Barry; D C Moriarty; P F Caushaj; J M Fitzpatrick; T F Gorey
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  130     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1995-10-05     Completed Date:  1995-10-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  984-8     Citation Subset:  AIM; IM    
Medical Center of Central Massachusetts, Worcester, USA.
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MeSH Terms
Laparoscopy / methods*
Pneumoperitoneum, Artificial*
Pulmonary Gas Exchange*
Random Allocation
Ventilation-Perfusion Ratio

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