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  • Poster presentation
  • Open Access

Pneumoperitoneum influence on the cardiovascular system evaluated by the PiCCO system

  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care200610 (Suppl 1) :P331

https://doi.org/10.1186/cc4678

  • Published:

Keywords

  • Mean Arterial Pressure
  • Cardiac Index
  • Hemodynamic Parameter
  • Cardiac Performance
  • Volumetric Data

Introduction

In laparoscopy the pneumoperitoneum, increasing intra-abdominal pressure, could impair cardiac performance and determine adverse cardiopulmonary effects. We have assessed the influence of laparoscopic surgery on selected hemodynamic-volumetric parameters by the PiCCO device (pulse contour analysis and transpulmonary technique).

Methods

Under general anaesthesia 16 patients, age 62 ± 13 years, ASA II-III (exclusion criteria: cardiovascular disease, neurological disease, pulmonary disease), nine male/seven female, were enrolled in two groups: Group A eight patients submitted to laparoscopic surgery; Group B, eight patients submitted to open surgery. In this randomised, controlled study the cardiac index (CI), global ejection fraction (GEF), mean arterial pressure (MAP), systemic vascular resistance index (SVRI), intrathoracic blood volume (ITBVI), index of ventricular contractility (Dp/Dtmax) and stroke volume index (SVI) were recorded. The hemodynamic and volumetric data are studied at T0 (after induction of anaesthesia), T1 (during pneumoperitoneum pressure at 12 ± 3 mmHg) and T2 (after deflation of the gas). Statistical analysis: ANOVA and Bonferroni multiple comparisons post-test to compare changes in the groups. All data are given as means ± SD and P < 0.05 is considered statistically significant.

Results

The hemodynamic parameters are not changed significantly between groups and in each group except for SVRI during pneumoperitoneum (P = 0.0077) (Table 1).

Table 1

 

Mean hemodynamic values

     
 

Group A

  

Group B

  
 

T0

T1

T2

T0

T1

T2

MAP (mmHg)

83.8 ± 11

83.8 ± 12

76.8 ± 11

80 ± 3

78.4 ± 4

79 ± 7

CI (l/min/m2)

3.38 ± 1

2.3 ± 0.8

2.4 ± 0.6

3.0 ± 0.3

2.5 ± 0.4

3.0 ± 0.1

GEF (%)

24.8 ± 5.5

21.8 ± 7.3

23 ± 5.6

30 ± 4

27 ± 5

28 ± 0.8

SVRI (dyn × s/cm5 × m)

1866 ± 623

3200 ± 1051*

1462 ± 397

1900 ± 143

1980 ± 220

2000 ± 160

ITBVI (ml/m2)

1011 ± 180

965 ± 272

965 ± 135

856 ± 64

870 ± 120

970 ± 69

Dp/Dtmax (mmHg/s)

889 ± 275

766 ± 248

875 ± 94.7

889 ± 220

1000 ± 113

1100 ± 228

SVI (ml/m2)

45.9 ± 14.5

38.8 ± 14

41.9 ± 10

48 ± 4

43 ± 8

48 ± 7

* P < 0.05.

Declarations

Acknowledgements

Grant from Dr A Annunziata.

Authors’ Affiliations

(1)
H.S. Giovanni, Rome, Italy

References

  1. Andersson L: Pneumoperitoneum versus abdominal wall lift: effects on central haemodynamics and intrathoracic pressure during laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2003, 47: 838-846. 10.1034/j.1399-6576.2003.00117.xView ArticlePubMedGoogle Scholar
  2. Galizia G: Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall-lifting cholecystectomy. A prospective, randomized study. Surg Endosc 2001, 15: 477-483. 10.1007/s004640000343View ArticlePubMedGoogle Scholar

Copyright

© BioMed Central Ltd 2006

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