Circulatory and respiratory complications of carbon dioxide insufflation.
Dig Surg
; 21(2): 95-105, 2004.
Article
em En
| MEDLINE
| ID: mdl-15010588
ABSTRACT
BACKGROUND:
Although providing excellent outcome results, laparoscopy also induces particular pathophysiological changes in response to pneumoperitoneum. Knowledge of the pathophysiology of a CO(2) pneumoperitoneum can help minimize complications while profiting from the benefits of laparoscopic surgery without concerns about its safety.METHODS:
A review of articles on the pathophysiological changes and complications of carbon dioxide pneumoperitoneum as well as prevention and treatment of these complications was performed using the Medline database.RESULTS:
The main pathophysiological changes during CO(2) pneumoperitoneum refer to the cardiovascular system and are mainly correlated with the amount of intra-abdominal pressure in combination with the patient's position on the operating table. These changes are well tolerated even in older and more debilitated patients, and except for a slight increase in the incidence of cardiac arrhythmias, no other significant cardiovascular complications occur. Although there are important pulmonary pathophysiological changes, hypercarbia, hypoxemia and barotraumas, they would develop rarely since effective ventilation monitoring and techniques are applied. The alteration in splanchnic perfusion is proportional with the increase in intra-abdominal pressure and duration of pneumoperitoneum.CONCLUSION:
A moderate-to-low intra-abdominal pressure (<12 mm Hg) can help limit the extent of the pathophysiological changes since consecutive organ dysfunctions are minimal, transient and do not influence the outcome.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumoperitônio Artificial
/
Dióxido de Carbono
/
Doenças Cardiovasculares
/
Gases
/
Pneumopatias
Tipo de estudo:
Etiology_studies
Limite:
Animals
/
Humans
Idioma:
En
Revista:
Dig Surg
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Alemanha