Acute ventilatory complications during laparoscopic upper abdominal surgery

Wahba, R. W. M.; Tessler, Michael J.; Kleiman, Simcha J.

doi:10.1007/bf03015963

Cited by 73 publications

(16 citation statements)

References 30 publications

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“…Da der Endotrachealtubus am Mundwinkel fixiert ist, kann die Tubusspitze bis zu 3 cm tiefer eindringen. Der Cuff des Tubus sollte daher bei der Intubation möglichst knapp unterhalb der Stimmbänder platziert werden ( [22]; . Tab.…”

Section: Sekundäre Einseitige Intubationunclassified

“…Tab. 3; [22]). Differenzialdiagnostisch kommt eine einseitige endobronchiale Intubation in Betracht.…”

Section: Pneumothoraxunclassified

“…Differenzialdiagnostisch kommen hier der Pneumothorax und die Gasembolie infrage. Sind diese ausgeschlossen, und ist der Patient trotz Beendigung des PP weiter hämodynamisch instabil, muss an diese seltene Komplikation gedacht werden [22]. Ein Pneumoperikard oder Pneumomediastinum kann mit der Echokardiographie am besten nachgewiesen werden.…”

Section: Pneumomediastinum/pneumoperikardunclassified

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Anästhesie bei laparoskopischen Eingriffen

Hömme

2011

Anaesthesist

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Laparoscopic techniques are used in many surgical disciplines and have partially become a standard procedure. Cholecystectomy is performed laparoscopically in 90% of cases. During a pneumoperitoneum changes occur which have a large influence on physiological homeostasis. Furthermore there are specific complications of laparoscopy which can have severe consequences. For adequate management the anesthetist has to be aware of both in order to react in the correct way.

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Section: Sekundäre Einseitige Intubationunclassified

“…Tab. 3; [22]). Differenzialdiagnostisch kommt eine einseitige endobronchiale Intubation in Betracht.…”

Section: Pneumothoraxunclassified

Section: Pneumomediastinum/pneumoperikardunclassified

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Anästhesie bei laparoskopischen Eingriffen

Hömme

2011

Anaesthesist

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“…Subcutaneous emphysema, perforation of intestinal loops, and hemorrhage represent important complications related to minimally invasive approaches [4,12]. Pneumothorax, cardiovascular collapse, hypoxia, and hypercarbia are some of the anesthesiologist's principal fears [15,18].…”

Section: Introductionmentioning

confidence: 99%

Anesthesiologic aspects of laparoscopic fundoplication for gastroesophageal reflux in children with chronic respiratory and gastroenterological symptoms

et al. 2003

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Carbon dioxide insufflation does not impair cardiovascular function, if intraabdominal pressure is maintained lower than 10 mmHg nor does it interfere with gas exchanges. Pneumoperitoneum slightly reduces ventilatory function, mainly in respiratory patients with various degrees of underlying bronchopulmonary impairments, but this effect is easily correctable. Thus, laparoscopic fundoplication is feasible and safe in both respiratory and gastroenterological patients, although surgery is easier and faster if periesophagitis is less evident.

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“…Intraoperative findings such as increased etCO 2 elevated airway pressure, and decreased lung compliance should alert the anesthesia team that pleural entry may have occurred. Hyperventilation, increasing minute volume, use of PEEP, and decreasing insufflation pressure can be helpful [14]. We believe that there is no need to discontinue the procedure so long as the patient remains stable.…”

Section: Discussionmentioning

confidence: 99%