Document Detail


Management of mechanical ventilation during laparoscopic surgery.
MedLine Citation:
PMID:  20608559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laparoscopy is widely used in the surgical treatment of a number of diseases. Its advantages are generally believed to lie on its minimal invasiveness, better cosmetic outcome and shorter length of hospital stay based on surgical expertise and state-of-the-art equipment. Thousands of laparoscopic surgical procedures performed safely prove that mechanical ventilation during anaesthesia for laparoscopy is well tolerated by a vast majority of patients. However, the effects of pneumoperitoneum are particularly relevant to patients with underlying lung disease as well as to the increasing number of patients with higher-than-normal body mass index. Moreover, many surgical procedures are significantly longer in duration when performed with laparoscopic techniques. Taken together, these factors impose special care for the management of mechanical ventilation during laparoscopic surgery. The purpose of the review is to summarise the consequences of pneumoperitoneum on the standard monitoring of mechanical ventilation during anaesthesia and to discuss the rationale of using a protective ventilation strategy during laparoscopic surgery. The consequences of chest wall derangement occurring during pneumoperitoneum on airway pressure and central venous pressure, together with the role of end-tidal-CO2 monitoring are emphasised. Ventilatory and non-ventilatory strategies to protect the lung are discussed.
Authors:
Franco Valenza; Giorgio Chevallard; Tommaso Fossali; Valentina Salice; Marta Pizzocri; Luciano Gattinoni
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical anaesthesiology     Volume:  24     ISSN:  1521-6896     ISO Abbreviation:  Best Pract Res Clin Anaesthesiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-07-22     Revised Date:  2011-04-28    
Medline Journal Info:
Nlm Unique ID:  101121446     Medline TA:  Best Pract Res Clin Anaesthesiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  227-41     Citation Subset:  IM    
Affiliation:
Università degli Studi di Milano, Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Via Festa del Perdono n.7, Milano, Italy. franco.valenza@unimi.it
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MeSH Terms
Descriptor/Qualifier:
Anesthesia / methods*
Body Mass Index
Carbon Dioxide / metabolism
Humans
Laparoscopy / adverse effects,  methods*
Monitoring, Intraoperative / methods
Pneumoperitoneum, Artificial / methods
Respiration, Artificial / methods*
Respiratory Mechanics
Time Factors
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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