Influence of pneumoperitoneum and patient positioning on preload and splanchnic blood volume in laparoscopic surgery of the lower abdomen

Retraction techniques in laparoscopic colorectal surgery: a literature‐based review

“…In certain cases it is poorly tolerated by patients, leading to cardiorespiratory compromise which creates anaesthetic difficulty due to restricted lung and diaphragmatic movements, decreased functional residual capacity and lung volumes which may lead to hypoxia, hypercapnoea and atelectasis. It can also cause a decrease in cardiac output by 10–30% resulting in cardiac ischaemia .…”

Elucidating the relationship between cardiac preload and renal perfusion under pneumoperitoneum

“…In the same patient population, Gannedahl et al [12] also found left ventricular end-diastolic area to be increased. In healthy women undergoing exploratory laparoscopic surgery of the lower abdomen, left ventricular end-diastolic area was increased at a pneumoperitoneum of 10 mmHg, and further increased when the intraabdominal pressure was raised to 15 mmHg [34].…”

Optimization of cardiac preload during laparoscopic donor nephrectomy: A preliminary study of central venous pressure versus esophageal doppler monitoring

“…Clinical studies using transesophageal echocardiography suggest that measures of preload either increase or do not change with CO 2 pneumoperitoneum. Rist et al, in a study of 10 healthy patients undergoing gynecologic laparoscopy, found that pneumoperitoneum increased left and right end diastolic area by almost 50%, which was thought to reflect a shift of blood from the abdomen to the thorax due to compression of the splanchnic vessels [21]. Gannedahl et al also documented an increase in end diastolic area in eight healthy patients during laparoscopic cholecystectomy [6], as did Harris et al in 12 patients undergoing laparoscopic colectomy, but only in the Trendelenburg position [8].…”