Document Detail


Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions. Laparoscopic cholecystectomy in pigs.
MedLine Citation:
PMID:  1386506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied the effects of laparoscopic cholecystectomy on respiratory and hemodynamic function in eight adult pigs. Minute ventilation was adjusted to normalize baseline arterial blood gases, then fixed throughout carbon dioxide insufflation. A metabolic measurement cart recorded total CO2 excretion, oxygen consumption, and minute ventilation. Carbon dioxide pneumoperitoneum was maintained at a constant pressure of 15 mm Hg as cholecystectomy was performed. After 1 hour of insufflation, CO2 excretion increased from 115 +/- 10 mL/min to 149 +/- 9 mL/min but O2 consumption remained unchanged. The PaCO2 increased from 35 +/- 2 mm Hg to 49 +/- 3 mm Hg and arterial pH fell from 7.47 +/- 0.02 to 7.35 +/- 0.03. Systemic and pulmonary hypertension occurred and stroke volume dropped from 35.5 +/- 3.5 mL to 28.6 +/- 2.2 mL with compensatory tachycardia. Right atrial pressure remained unchanged as inferior vena cava pressure increased to reflect the intraperitoneal pressure. We conclude that CO2 pneumoperitoneum resulted in significant transperitoneal CO2 absorption, with secondary hypercapnia and acidemia. The accumulation of CO2 was also associated with an increase in systemic and pulmonary arterial pressure. Heart rate increased to compensate for the decreased stroke volume to maintain cardiac output.
Authors:
H S Ho; R A Gunther; B M Wolfe
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  127     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-02     Completed Date:  1992-09-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  928-32; discussion 932-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium / physiology
Animals
Carbon Dioxide / physiology*
Cholecystectomy / methods*
Hemodynamics / physiology*
Homeostasis / physiology
Insufflation*
Laparoscopy*
Swine
Grant Support
ID/Acronym/Agency:
2T32GM07860-12/GM/NIGMS NIH HHS; 35747//PHS HHS
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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