Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions

Laparoscopic cholecystectomy in pigs

Hung S Ho, R. A. Gunther, B. M. Wolfe

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

We studied the effects of laparoscopic cholecystectomy on respiratory and hemodynamic function in eight adult pigs. Minute ventilation was adjusted to normalize baseline arterial blood gases, then fixed throughout carbon dioxide insufflation. A metabolic measurement cart recorded total CO2 excretion, oxygen consumption, and minute ventilation. Carbon dioxide pneumoperitoneum was maintained at a constant pressure of 15 mm Hg as cholecystectomy was performed. After 1 hour of insufflation, CO2 excretion increased from 115±10 mL/min to 149±9 mL/min but O2 consumption remained unchanged. The PaCO2 increased from 35±2 mm Hg to 49±3 mm Hg and arterial pH fell from 7.47±0.02 to 7.35±0.03. Systemic and pulmonary hypertension occurred and stroke volume dropped from 35.5±3.5 mL to 28.6±2.2 mL with compensatory tachycardia. Right atrial pressure remained unchanged as inferior vena cava pressure increased to reflect the intraperitoneal pressure. We conclude that CO2 pneumoperitoneum resulted in significant transperitoneal CO2 absorption, with secondary hypercapnia and acidemia. The accumulation of CO2 was also associated with an increase in systemic and pulmonary arterial pressure. Heart rate increased to compensate for the decreased stroke volume to maintain cardiac output.

Original languageEnglish (US)
Pages (from-to)928-933
Number of pages6
JournalArchives of Surgery
Volume127
Issue number8
StatePublished - 1992

Fingerprint

Insufflation
Laparoscopic Cholecystectomy
Carbon Dioxide
Pneumoperitoneum
Swine
Pressure
Stroke Volume
Ventilation
Atrial Pressure
Hypercapnia
Inferior Vena Cava
Cholecystectomy
Pulmonary Hypertension
Tachycardia
Oxygen Consumption
Cardiac Output
Arterial Pressure
Heart Rate
Gases
Hemodynamics

ASJC Scopus subject areas

  • Surgery

Cite this

Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions : Laparoscopic cholecystectomy in pigs. / Ho, Hung S; Gunther, R. A.; Wolfe, B. M.

In: Archives of Surgery, Vol. 127, No. 8, 1992, p. 928-933.

Research output: Contribution to journalArticle

@article{61fce0b1fe1e487fa4a651d9d0ba2c31,
title = "Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions: Laparoscopic cholecystectomy in pigs",
abstract = "We studied the effects of laparoscopic cholecystectomy on respiratory and hemodynamic function in eight adult pigs. Minute ventilation was adjusted to normalize baseline arterial blood gases, then fixed throughout carbon dioxide insufflation. A metabolic measurement cart recorded total CO2 excretion, oxygen consumption, and minute ventilation. Carbon dioxide pneumoperitoneum was maintained at a constant pressure of 15 mm Hg as cholecystectomy was performed. After 1 hour of insufflation, CO2 excretion increased from 115±10 mL/min to 149±9 mL/min but O2 consumption remained unchanged. The PaCO2 increased from 35±2 mm Hg to 49±3 mm Hg and arterial pH fell from 7.47±0.02 to 7.35±0.03. Systemic and pulmonary hypertension occurred and stroke volume dropped from 35.5±3.5 mL to 28.6±2.2 mL with compensatory tachycardia. Right atrial pressure remained unchanged as inferior vena cava pressure increased to reflect the intraperitoneal pressure. We conclude that CO2 pneumoperitoneum resulted in significant transperitoneal CO2 absorption, with secondary hypercapnia and acidemia. The accumulation of CO2 was also associated with an increase in systemic and pulmonary arterial pressure. Heart rate increased to compensate for the decreased stroke volume to maintain cardiac output.",
author = "Ho, {Hung S} and Gunther, {R. A.} and Wolfe, {B. M.}",
year = "1992",
language = "English (US)",
volume = "127",
pages = "928--933",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions

T2 - Laparoscopic cholecystectomy in pigs

AU - Ho, Hung S

AU - Gunther, R. A.

AU - Wolfe, B. M.

PY - 1992

Y1 - 1992

N2 - We studied the effects of laparoscopic cholecystectomy on respiratory and hemodynamic function in eight adult pigs. Minute ventilation was adjusted to normalize baseline arterial blood gases, then fixed throughout carbon dioxide insufflation. A metabolic measurement cart recorded total CO2 excretion, oxygen consumption, and minute ventilation. Carbon dioxide pneumoperitoneum was maintained at a constant pressure of 15 mm Hg as cholecystectomy was performed. After 1 hour of insufflation, CO2 excretion increased from 115±10 mL/min to 149±9 mL/min but O2 consumption remained unchanged. The PaCO2 increased from 35±2 mm Hg to 49±3 mm Hg and arterial pH fell from 7.47±0.02 to 7.35±0.03. Systemic and pulmonary hypertension occurred and stroke volume dropped from 35.5±3.5 mL to 28.6±2.2 mL with compensatory tachycardia. Right atrial pressure remained unchanged as inferior vena cava pressure increased to reflect the intraperitoneal pressure. We conclude that CO2 pneumoperitoneum resulted in significant transperitoneal CO2 absorption, with secondary hypercapnia and acidemia. The accumulation of CO2 was also associated with an increase in systemic and pulmonary arterial pressure. Heart rate increased to compensate for the decreased stroke volume to maintain cardiac output.

AB - We studied the effects of laparoscopic cholecystectomy on respiratory and hemodynamic function in eight adult pigs. Minute ventilation was adjusted to normalize baseline arterial blood gases, then fixed throughout carbon dioxide insufflation. A metabolic measurement cart recorded total CO2 excretion, oxygen consumption, and minute ventilation. Carbon dioxide pneumoperitoneum was maintained at a constant pressure of 15 mm Hg as cholecystectomy was performed. After 1 hour of insufflation, CO2 excretion increased from 115±10 mL/min to 149±9 mL/min but O2 consumption remained unchanged. The PaCO2 increased from 35±2 mm Hg to 49±3 mm Hg and arterial pH fell from 7.47±0.02 to 7.35±0.03. Systemic and pulmonary hypertension occurred and stroke volume dropped from 35.5±3.5 mL to 28.6±2.2 mL with compensatory tachycardia. Right atrial pressure remained unchanged as inferior vena cava pressure increased to reflect the intraperitoneal pressure. We conclude that CO2 pneumoperitoneum resulted in significant transperitoneal CO2 absorption, with secondary hypercapnia and acidemia. The accumulation of CO2 was also associated with an increase in systemic and pulmonary arterial pressure. Heart rate increased to compensate for the decreased stroke volume to maintain cardiac output.

UR - http://www.scopus.com/inward/record.url?scp=0026781495&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026781495&partnerID=8YFLogxK

M3 - Article

VL - 127

SP - 928

EP - 933

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 8

ER -