Document Detail

Transesophageal echocardiographic assessment of hemodynamic function during laparoscopic cholecystectomy in healthy patients.
MedLine Citation:
PMID:  10656941     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study aimed by means of transesophageal echocardiography, to evaluate hemodynamic changes induced by pneumoperitoneum in patients with normal cardiac performance. METHODS: In this study, 11 ASA I-II patients (mean age, 39 years) with normal cardiac performance undergoing laparoscopic cholecystectomy were evaluated. A 5-MHz transesophageal biplane phased-array transducer connected to an echocardiographer was inserted after induction of anesthesia. Data were collected at three different times: before insufflation (T1), 10 min after insufflation (T2), and 5 min after desufflation (T3). At these same times, heart rate, systolic blood pressure, diastolic blood pressure, end-tidal carbon dioxide (CO(2)), and peak airway pressure were recorded. Statistical analysis was performed using one-way and two-way analysis of variance (ANOVA). A p value less than 0.05 was considered significant. RESULTS: End-systolic and end-diastolic diameters of the left ventricle, contractility, and performance parameters did not change significantly. Conversely, at insufflation, color Doppler area of the mitral backflow increased significantly (p < 0.05) when already present or showed up abruptly (T1: 0.22 +/- 0.28 cm(2); T2: 1.28 +/- 1.02 cm(2); T3: 0.49 +/- 0.53 cm(2)). CONCLUSIONS: Such an event is not interpreted as a mitral insufficiency. It is possibly the result of a "contrast effect" caused by the absorption of CO(2) microbubbles in the blood.
D D'Ugo; R Persiani; F Pennestri; E Adducci; P Primieri; V Pende; G De Cosmo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  14     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-02     Completed Date:  2000-03-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  120-2     Citation Subset:  IM    
Department of Surgery, Catholic University of Rome, "A Gemelli" Medical School, Largo F. Vito 1, 00168 Rome, Italy.
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MeSH Terms
Carbon Dioxide
Cholecystectomy, Laparoscopic*
Echocardiography, Doppler
Echocardiography, Transesophageal*
Pneumoperitoneum, Artificial*
Ventricular Function, Left*
Reg. No./Substance:
124-38-9/Carbon Dioxide

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