Renal hemodynamics during carbon dioxide pneumoperitoneum

Lindberg, Fredrik; Bergqvist, David; Björck, Martin; Rasmussen, I

doi:10.1007/s00464-002-9044-y

Cited by 54 publications

(36 citation statements)

References 18 publications

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“…Pneumoperitoneum, added warm ischemia time, and graft function Pneumoperitoneum itself has well-known hemodynamic effects on the kidney: Renal blood flow is reduced, renal venous pressure is increased, and urine output can be reduced [38]. However, data from the existing reviews and RCTs concerning delayed graft function and recipient creatinine levels show equivalent outcome for LDN when compared to ODN.…”

Section: Multiple Vesselsmentioning

confidence: 89%

Current concepts in transplant surgery: laparoscopic living donor of the kidney

Paul

Treckmann

Gallinat

et al. 2007

Langenbecks Arch Surg

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Section: Multiple Vesselsmentioning

confidence: 89%

Current concepts in transplant surgery: laparoscopic living donor of the kidney

Paul

Treckmann

Gallinat

et al. 2007

Langenbecks Arch Surg

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“…However, there is compelling evidence that pneumoperitoneum reduces renal blood flow [3,9,10,17], and this has also been shown in pigs [7]. Compared with open operation, endoscopic dissection requires longer surgical manipulation in the vicinity of the renal artery, with the potential to cause arterial spasm.…”

Section: Discussionmentioning

confidence: 99%

Periarterial application of papaverine during laparoscopic donor nephrectomy improves early graft function after kidney transplantation in pigs

et al. 2004

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“…Studies on the effects of increased intraabdominal pressure and volume expansion on renal function with the use of animals, such as rats (Hazebroek et al, 2003;Fagundes, Montero, Novo, & Bandeira, 2001;Lee et al, 1999), pigs (London et al, 2000;Lindberg, Bergqvist, Bjorck, & Rasmussen, 2003;Gudmundsson, Viste, & Myking, 2003), rabbits (Guler, Sade, & Kirkali, 1998;Bentes de Souza, Wang, & Chu, 2003) and humans (Hawasli et al, 2003;Nguyen, Perez, Fleming, Rivers, & Wolfe, 2002;Pérez et al, 2002), have brought new knowledge on oliguria, which occurs in laparoscopic procedures and how to reduce such deleterious effects.…”

Section: Introductionmentioning

confidence: 99%

<b>The role of pneumoperitoneum in the glomerular filtration in an experimental model with 2/3 reduction of the renal mass

Valadão¹,

Fagundes²,

Cavazana³

et al. 2017

Acta Sci. Health Sci.

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ABSTRACT. Objective: To evaluate the influence of the CO 2 pneumoperitoneum in the glomerular filtration in a rat model with a 2/3 reduction of renal parenchyma. Methods: Adult Wistar male rats (n = 50) were subjected to right nephrectomy and a 2/3 ligature of the renal left vascular branch. Animals were randomly distributed as follows: GI (n = 10) -simulated, GII (n = 20) -8 mm Hg pneumoperitoneum, and GIII (n = 20) -15 mm Hg pneumoperitoneum. After two (GIIA and GIIIA) and three (GIIB and GIIIB) hours of insufflation, and one hour of disinsufflation, they were evaluated for the following aspects: mean blood pressure (MBP), microhematocrit, urinary volume and inulin clearance. Results: The microscopic aspects showed signs of glomerulosclerosis that caused proteinuria. Renal function with 8 mm Hg pneumoperitoneum after two hours of disinsufflation (Δ% = 202.68) was better than after three hours (Δ% = 10.89). With 15 mm Hg pneumoperitoneum, the renal function was damaged by both procedures, that is, two (Δ% = -3.57) and three hours (Δ% = -3.25). Conclusion: Inulin clearance evidenced renal insufficiency in the model with a 2/3 reduction of renal mass, and depending on both the increase of the exposure time and the pressure intensity, it can be more intensified.Keywords: inulin, kidney failure, pneumoperitoneum, video-assisted surgery.O papel do pneumoperitônio na função renal em um modelo experimental de redução de 2/3 do parênquima renal RESUMO. Este estudo tem como objetivo avaliar a influência do pneumoperitônio induzido CO 2 sobre a função renal em um modelo em ratos com redução de 2/3 de sua massa renal. Em relação à metodologia, ratos Wistar (n=50), machos, adultos, foram submetidos à nefrectomia direita e ligadura de 2/3 do pedículo vascular renal esquerdo. A seguir, foram aleatoriamente distribuídos em GI (n=10)-Simulado, GII (n=20) com pneumoperitônio de 8 mmHg e GIII (n=20) compneumoperitônio de 15 mmHg, por uma hora. Após duas (GIIA e GIIIA) e três (GIIB e GIIIB) horas da desinsuflação, foram avaliadas a pressão arterial média (PAM), micro-hematócrito, volume urinário e clearance da inulina. Os resultados da microscopia mostraram que o rim remanescente apresentou sinais de glomeruloesclerose, caracterizada pela proteinúria. A função renal com pneumoperitônio de 8 mmHg após duas horas da insuflação (Δ%=202,68) foi melhor do que com três horas (Δ%= 10,89). Com o pneumoperitônio de 15 mmHg tanto com duas (Δ%=-3,57) quanto três horas (Δ%=-3,25), a função renal esteve prejudicada. Concluiu-se que oclearance da inulina mostrou haver um comprometimento da função renal no modelo de redução de 2/3 do parênquima e que, dependendo do volume e do tempo de pneumoperitônio, pode ser agravada.Palavras-chave: inulina, insuficiência renal, pneumoperitônio, cirurgia vídeo-assistida.

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Renal hemodynamics during carbon dioxide pneumoperitoneum

Abstract: A CO2 PP of 12 mmHg causes changes in renal hemodynamics and urine output. No changes in vasopressin levels were seen in this pig model, suggesting that other explanations for the observed changes must be sought.

Cited by 54 publications

References 18 publications

Current concepts in transplant surgery: laparoscopic living donor of the kidney

Current concepts in transplant surgery: laparoscopic living donor of the kidney

Periarterial application of papaverine during laparoscopic donor nephrectomy improves early graft function after kidney transplantation in pigs

<b>The role of pneumoperitoneum in the glomerular filtration in an experimental model with 2/3 reduction of the renal mass

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