Laparoscopic surgery in children is associated with an intraoperative hypermetabolic response

McHoney, Merrill; Corizia, Lucia; Eaton, Simon; Wade, Angie; Spitz, Lewis; Drake, D. P.; Kiely, Edward M.; Tan, Hock Lim; Pierro, Agostino

doi:10.1007/s00464-004-2274-4

Cited by 31 publications

(15 citation statements)

References 18 publications

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“…We were interested in trying to measure this absorbed CO 2 in children. Although we saw an increase in exhaled CO 2 , which was relatively greater in younger children,22 as there was a change in oxygen consumption over the same time period,23 we could not be certain whether this increase in CO 2 was due to increased CO 2 absorption, or to increased metabolic CO 2 production. Assuming that the increase in metabolically produced CO 2 is proportional to the increase in O 2 consumption, the amount of CO 2 absorbed from the peritoneum can be estimated, although this calculation is rather crude (Fig.…”

Section: Endoscopic Surgery and Alterations In 13co2/12co2mentioning

confidence: 77%

Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Eaton

Pacilli

Wood

et al. 2008

Rapid Comm Mass Spectrometry

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Section: Endoscopic Surgery and Alterations In 13co2/12co2mentioning

confidence: 77%

Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Eaton

Pacilli

Wood

et al. 2008

Rapid Comm Mass Spectrometry

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“…[5] However, this assumption regarding the impact of laparoscopic surgery on endocrine and metabolic responses in children has not been widely tested. [6]…”

Section: Discussionmentioning

confidence: 99%

Nephrectomy in children: Comparison of stress response to laparoscopic and open methods

Sekhon

Menon

Arora

et al. 2013

J Indian Assoc Pediatr Surg

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Aim:To evaluate and compare the extent of surgical stress following laparoscopic nephrectomy (LN) and open nephrectomy (ON) in children.Materials and Methods:Twenty consecutive children undergoing nephrectomy were randomized to LN or ON groups. Acid-base balance, blood glucose, acute phase proteins (C-reactive protein [CRP]) and inflammatory markers (interleukin-6 [IL-6]) were measured pre-operatively, as well as 4 and 24 h after surgery. The differences between the two groups were analyzed statistically (significance value for P < 0.05).Results:The overall acid base status was more stable in LN. The fall in pH 4 h after surgery was more in ON (P = 0.440) and the difference in pH in ON 4 h and 24 h post-operatively was statistically significant (P = 0.002). In LN, significant difference was found in the base excess mean pre-surgery (mean –3.280 mEq/L) and 4 h post-surgery (mean –7.480 mEq/L) (P = <0.05), as well as between 4 h and 24 h after surgery (mean –2.660 mEq/L) (P = 0.011). The acute rise in CRP 24 h post-operatively in the ON (88.972 mg/L) was significantly higher when compared to both the pre-operative and 4 h post-operative values (P < 0.05). This rise was however, not statistically significant when compared to the 24 h post-operative value in LN (46.399 mg/L) (P = 0.062). The rise in IL-6, 24 h post-procedure in LN (mean 44.444 pg/ml) was statistically lower than that in the open group (mean 343.333 pg/ml) (P = 0.041).Conclusions:The stable acid-base status and lesser rise of CRP and IL-6 in LN lead to the conclusion that surgical stress caused by LN is less than ON.

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“…An increase in systemic vascular resistance as a consequence of compression of the aorta causes splanchnic arteriolar vasoconstriction and potential anuria . Establishment of a pneumoperitoneum causes an intraoperative hypermetabolic status with a subsequent increase in oxygen consumption . Various cardiac arrhythmias are also observed during laparoscopies in small babies .…”

Section: Modifications In Surgical Strategiesmentioning

confidence: 99%

Awake caudals and epidurals should be used more frequently in neonates and infants

Marhofer

Keplinger

Klug

et al. 2014

Pediatric Anesthesia

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The current literature provides fundamental insights regarding the neurotoxic potency of various general anesthetic drugs in neonates and small infants. Therefore, considerations to minimize the use of general anesthetic drugs in this age group are required. The use of caudal and epidural anesthesia under sedation is one possibility to minimize the use of general anesthetic drugs. A large number of surgical procedures can be managed with this anesthetic concept. Training, practical hand skills, good infrastructure, a well-defined indication, and a team approach including the entire operation room staff are the major prerequisites to implement these techniques in the daily clinical practice. This review article discusses all present aspects and possible future evolutions of caudal and epidural anesthesia under sedation.

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Laparoscopic surgery in children is associated with an intraoperative hypermetabolic response

Abstract: Laparoscopy in children is associated with an intraoperative hypermetabolic response characterized by increased oxygen consumption and core temperature. These changes are more marked in younger children.

Cited by 31 publications

References 18 publications

Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Nephrectomy in children: Comparison of stress response to laparoscopic and open methods

Awake caudals and epidurals should be used more frequently in neonates and infants

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Laparoscopic surgery in children is associated with an intraoperative hypermetabolic response

Abstract: Laparoscopy in children is associated with an intraoperative hypermetabolic response characterized by increased oxygen consumption and core temperature. These changes are more marked in younger children.

Cited by 31 publications

References 18 publications

Factors affecting 13C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Factors affecting 13C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Nephrectomy in children: Comparison of stress response to laparoscopic and open methods

Awake caudals and epidurals should be used more frequently in neonates and infants

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Product

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Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

Factors affecting ¹³C‐natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures