Elucidating the relationship between cardiac preload and renal perfusion under pneumoperitoneum

Bergman, Simon; Nutting, Arni; Feldman, Liane S.; Vassiliou, Melina C.; Andrew, Christopher G.; Demyttenaere, Sebastian; Woo, D.; Carli, Franco; Jutras, Luc; Buthieu, Jean; Stanbridge, D.; Fried, Gerald M.

doi:10.1007/s00464-005-0086-9

Cited by 14 publications

(10 citation statements)

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“…The pigs demonstrated great baseline variability, unlike kidney donor patients, who are a fairly homogeneous, healthy population [12]. Although we perform donor nephrectomy clinically at a pneumoperitoneum of 12 mmHg, we chose to use 15 mmHg in this study because we were unable to demonstrate significant changes in systemic and renal hemodynamics at 12 mmHg in a previous porcine study [2]. Nonetheless, Perez et al [31] found a decrease in urine output and creatinine clearance in patients undergoing laparoscopic colon surgery with a pneumoperitoneum of 15 mmHg, despite using crystalloids to maintain the CVP between 10 and 12 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…This decreases cardiac output, which results in a decrease in effective circulating blood volume and RCP [1,27]. However, we were previously unable to demonstrate a decrease in an index of preload in patients during LLDN at 12-15 mmHg pneumoperitoneum [12] or in a pig model [2,3], and others have even demonstrated an increase in preload during pneumoperitoneum [13,17].…”

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confidence: 95%

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Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion?

et al. 2005

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Section: Discussionmentioning

confidence: 99%

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confidence: 95%

Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion?

et al. 2005

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“…In terms of the effects of pneumoperitoneum on cardiac preload and renal perfusion, Bergman et al [8] reported that cardiac preload decreases with pneumoperitoneum and a decrease in preload deepens with concomitant nitroglycerin infusion. Further, renal perfusion is not significantly decreased by pneumoperitoneum alone, but it is decreased when infusion of nitroglycerin is also performed.…”

Section: Discussionmentioning

confidence: 99%

The effect of nitroglycerin on hemodynamic changes during laparoscopic low anterior resection

Moon

Lee

Choi

et al. 2011

Korean J Anesthesiol

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BackgroundMore laparoscopic low anterior resections (LAR) are being performed in recent years. There has been controversy around the hemodynamic changes affected by the Trendelenburg position and pneumoperitoneum during LAR. The goal of this study was to analyze the effect of nitroglycerin (NTG) on hemodynamic changes during LAR.MethodsForty ASA physical status I-II patients undergoing LAR were randomized into two groups: the NTG infused group (N group, n = 20) and the control group (C group, n = 20). Anesthesia was maintained with sevoflurane at 1-3 vol%, air/oxygen (50%/50%) and continuous infusion with remifentanil. The N group patients were given 0.5 µg/kg/min of NTG during anesthesia. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), cardiac index (CI), stroke volume (SV) and systemic vascular resistance (SVR) were assessed 10 min after induction (T1), 5 min after pneumoperitoneum in the supine position (T2), 10 min after pneumoperitoneum in the Trendelenburg position (T3), 30 min after pneumoperitoneum in the Trendelenburg position (T4), 1 hr after pneumoperitoneum in the Trendelenburg position (T5) in addition to 5 (T6), 10 (T7) and 30 min (T8) after removal of the pneumoperitoneum in the supine position.ResultsThe increases of MAP were milder in the N group (22.6-7.3%) than the C group (32.3-17.7%) during pneumoperitoneum and while in the Trendelenburg position. The significant decreases of HR were maintained in the C group, but the changes in HR were not significant in N group during the operation. The increases in CVP were less in N group than C group. The increases of SVR were milder in N group (19.4-1.4%) than C group (41.7-16.6%) during pneumoperitoneum in the Trendelenburg position.ConclusionsIntraoperative NTG infusions were effective to some degree in reducing the hemodynamic changes during pneumoperitoneum with Trendelenburg positioning for LAR.

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“…The animal model used has been previously described [2]. Briefly, eight female pigs were fasted overnight with free access to water.…”

Section: Animals and Anesthesiamentioning

confidence: 99%

Validation of esophageal Doppler for noninvasive hemodynamic monitoring under pneumoperitoneum

et al. 2007

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Elucidating the relationship between cardiac preload and renal perfusion under pneumoperitoneum

Abstract: While decreasing preload under extreme lab conditions also decreases RCP, simply creating a pneumoperitoneum of 12 mmHg does not. The decrease in renal blood flow associated with pneumoperitoneum is likely not solely a function of preload.

Cited by 14 publications

References 37 publications

Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion?

Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion?

The effect of nitroglycerin on hemodynamic changes during laparoscopic low anterior resection

Validation of esophageal Doppler for noninvasive hemodynamic monitoring under pneumoperitoneum

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