Ventilatory effects of pneumoperitoneum monitored with continuous spirometry

Abstract

SummaryInspiratory and expiratory tidal volume, peak and plateau airway pressure, compliance of the respiratory system, pressurevolume and jow-volume loops were monitored continuously and recorded in seven women undergoing laparoscopy with carbon dioxide insujflation to an intra-abdominal pressure of 1.6 k Pa. AN patients were anaesthetised using a total intravenous technique and a constant minute ventilation was maintained. Peak airway and plateau airway pressures increased by 50% and 81% respectively, whilst the compliance of the respiratory system decreased by 47% during the period of increased intra-abdominal pressure. Following release of the pneumoperitoneum, peak and plateau pressures remained elevated by 37% and 27% respectively, and the compliance was 86% of the pre-insuflation value. On-line monitoring of respiratory volumes, pressures and compliance may be helpful during general anaesthesia for laparoscopic procedures to avoid the potential harmful effects of increased airway pressures occurring with increased intra-abdominal pressure.

Laparoscopic cholecystectomy using abdominal wall retraction

“…Indeed, in our study peak airway pressures increased during laparoscopy using conventional pneumoperitoneum. This finding is in agreement with those of others who reported increased peak and plateau airway pressures secondary to reduced compliance during laparoscopy [2]. In contrast, during abdominal wall retraction peak airway pressures did not increase.…”

“…Respiratory acidosis develops using conventional pneumoperitoneum as shown by the increase of the arterial PCO 2 and pH. The use of AWR was also associated with the gradual development of respiratory acidosis.…”

“…The following ventilatory parameters were measured; end-tidal CO 2 (EtCO 2 ), arterial pH, arterial PCO 2 , arterial PO 2 , and peak inspiratory pressure. End-tidal CO 2 was measured with an infrared mainstream transducer (Hewlett Packard, Saronno, Italy). Blood-gas samples were analyzed by a routine method (ABL 4, Radiometer A/S, Copenhagen, Denmark).…”

The effects of pneumoperitoneum pressure on blood gases, respiratory and venous systems during laparoscopic cholecystectomy: A prospective randomized trial

“…As IAP increases, dynamic compliance reduces whereas airway pressure, PP, and plateau pressures increase. [17][18][19][20][21][22] In our study, significant decreases in DC and increases in PIP during PP in both high and low PP groups were detected. In reference to the high PP group, decrease in DC and increase in PIP were less significant in low PP group.…”

Correlação entre as pressões parciais de co2 no ar expirado e no sangue arterial, em porcas submetidas a pneumoperitônio

“…A insuflação peritonial com CO 2 pode produzir acidose devido a absorção de gás pelo peritônio e piora da ventilação com o aumento do espaço morto 16 .O volume de CO 2 excretado atinge um platô ao redor de dez minutos de insuflação. A absorção de CO 2 da cavidade peritonial não segue linearidade com o aumento progressivo da pressão de insuflação intra-abdominal, sua absorção de CO 2 parece alcançar o máximo com relativa baixa pressão de insuflação e não aumenta significativamente, apesar do aumento da pressão de insuflação.…”