Effect of pneumoperitoneum on renal perfusion and function: A systematic review

Demyttenaere, Scbastian; Feldman, Liane S.; Fried, Gerald M.

doi:10.1007/s00464-006-0250-x

Cited by 173 publications

(124 citation statements)

References 57 publications

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“…Whereas many studies report renal dysfunction 7,1,9 , it is certainly not a consensus finding in the literature, whereas oliguria is. Demyttenaere et al 12 reviewed seven studies which used rodent models of PP, and in three, no change in renal function was found after PP. These inconsistencies are probably due to the difficulty of measuring renal function in the acute setting 2,12 , and this is also a limitation of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Demyttenaere et al 12 reviewed seven studies which used rodent models of PP, and in three, no change in renal function was found after PP. These inconsistencies are probably due to the difficulty of measuring renal function in the acute setting 2,12 , and this is also a limitation of the present study. Creatinine clearance is not as precise in the short term as it is chronically 12 , though it has been employed in some studies in this field 10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…Carbon dioxide (CO 2 ) is the gas employed most widely for insufflation, given that it is noncombustible, relatively inexpensive and highly soluble in blood, minimizing the risk of embolism [2][3]6 . However, PP increases intra-abdominal pressure, which has been shown to produce oliguria and renal dysfunction in both animal and clinical studies [1][2][4][5][6][7][8][9][10][11][12] . In healthy young patients, these changes tend to be mild and reversible due to the various physiologic mechanisms for CO 2 buffering and elimination 2,12 .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, no major clinical consequences are observed. In patients with underlying renal impairment, however, these renal effects may be of clinical significance, thus increasing the morbidity of the procedure [2][3]7,12 . This situation is becoming common due to widespread use of laparoscopic techniques, which were formerly restricted to "optimal" candidates but are currently used in an increasing number of patients with comorbidities 1-2,8-9 .…”

Section: Introductionmentioning

confidence: 99%

“…These adverse effects are also relevant in laparoscopic nephrectomies for live donor transplantation, due to concerns regarding possible PP-related graft damage 1,4-5,13-14 . Despite extensive research in the last two decades, the exact mechanisms responsible for the renal effects of PP have not been entirely elucidated 5,12 . Vascular and parenchymal compression certainly plays a role, though hormonal factors 1-2,5-7,10-11 and, more recently, oxidative stress 4,9,13 have been suggested as well.…”

Section: Introductionmentioning

confidence: 99%

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Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Freitas¹,

Durães²,

Carvalho³

et al. 2013

Acta Cir. Bras.

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PURPOSE:To evaluate the effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in a rat model. METHODS:Twenty four rats were randomized into three groups (n=8): gasless insufflation ('open', Pressure=0 mmHg), carbon dioxide pneumoperitoneum at 12 mmHg, and helium pneumoperitoneum at 12 mmHg; all lasting 90 minutes.. A cystostomy was performed and the bladder was emptied. At the end of the experiment, the urine produced, a blood sample and the left kidney of each animal were collected. The following variables were obtained: serum sodium, potassium, urea and creatinine, urine volume and creatinine. The creatinine clearance was estimated for each animal. The kidneys were stained with hematoxylin and eosin (HE) and evaluated by a pathologist blinded to the groups. RESULTS:The CO 2 and Helium groups did not differ in the variables evaluated. Both developed oliguria (p<0.001 vs. gasless). The CO 2 group presented hyperkalemia compared to gasless (p=0.05), which did not attain significance in the helium group. Histopathological analysis revealed mild hydropic degeneration and congestion in the three groups, with no significant difference among them. CONCLUSIONS:The type of gas resulted in no difference in the variables of renal function and morphology assessed. The increase in serum potassium was only observed with CO 2 insufflation suggests a combined effect of elevated intra-abdominal pressure and metabolic effects of pneumoperitoneum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Freitas¹,

Durães²,

Carvalho³

et al. 2013

Acta Cir. Bras.

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Anesthetic Management During Laparoscopic/Robotic Surgery

Aronsohn

Dowling

Palleschi

2018

Smith's Textbook of Endourology

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Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study

Collaborative¹

2018

BJS Open

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BackgroundAcute illness, existing co‐morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery.MethodsThis prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2‐week blocks over a continuous 3‐month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation.ResultsA total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30‐day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30‐day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin‐converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c‐statistic 0·65).DiscussionFollowing major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability.

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Effect of pneumoperitoneum on renal perfusion and function: A systematic review

Cited by 173 publications

References 57 publications

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats

Anesthetic Management During Laparoscopic/Robotic Surgery

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study

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