Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide

Laparoscopic surgery has rapidly become a popular and widely used technique. Although this procedure has been shown to be generally safe, cardiovascular derangement related to carbon dioxide pneumoperitoneum has been reported. There are few data available on the relationship between systemic and reg...

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Bibliographic Details
Published in:Surgical endoscopy 1993-09, Vol.7 (5), p.420-423
Main Authors: ISHIZAKI, Y, BANDAI, Y, SHIMOMURA, K, ABE, H, OHTOMO, Y, IDEZUKI, Y
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Carbon Dioxide
Dogs
Hemodynamics - physiology
Intraoperative Care
Laparoscopy
Liver, biliary tract, pancreas, portal circulation, spleen
Medical sciences
Pneumoperitoneum, Artificial
Splanchnic Circulation - physiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
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Summary:Laparoscopic surgery has rapidly become a popular and widely used technique. Although this procedure has been shown to be generally safe, cardiovascular derangement related to carbon dioxide pneumoperitoneum has been reported. There are few data available on the relationship between systemic and regional hemodynamics in cases of pneumoperitoneum. Changes in splanchnic blood flow and cardiovascular effects following a moderate increase of intraabdominal pressure (IAP) to 16 mmHg during a 3-h period were analyzed in six anesthetized dogs. After insufflation, cardiac output and blood flow in the superior mesenteric artery and portal vein decreased progressively and returned to the preinsufflation values following deflation. Hepatic arterial blood flow did not change significantly, perhaps due to compensatory mechanisms for maintenance of hepatic blood flow. Mechanical compression of the splanchnic capillary beds due to the elevated IAP may possibly reflect the increase in systemic vascular resistance causing the decrease in cardiac output. To prevent this impairment, intermittent decompression of gas during surgical laparoscopy is recommended.
ISSN:0930-2794
1432-2218
DOI:10.1007/bf00311734