title: Cardiorespiratory effects of laparoscopy with and without gas insufflation.
abstract: BACKGROUND
  Patients who are undergoing laparoscopic procedures can present with a number of ventilatory and circulatory problems. The use of a gasless technique for performing a laparoscopy by using a mechanical lifting device may potentially avoid such problems.
  
  
  OBJECTIVE
  To compare the cardiorespiratory effects of laparoscopy with and without gas insufflation.
  
  
  METHODS
  Twelve adult pigs were randomized to undergo a laparoscopy by using either carbon dioxide insufflation or mechanical elevation. Full invasive monitoring was performed preoperatively and at 10-minute intervals throughout the operative period. Parameters that were measured included blood gas determinations, mean arterial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac output, stroke volume, and total peripheral resistance.
  
  
  RESULTS
  Carbon dioxide insufflation unlike mechanical elevation led to a fall in PO2 and absorption of a significant quantity of CO2, resulting in hypercapnia, acidosis, and a consequent hyperdynamic circulation.
  
  
  CONCLUSIONS
  These findings have significant implications for the use of CO2 insufflation for laparoscopy in patients with a compromised respiratory or cardiac status.
authors.affiliation: Medical Center of Central Massachusetts, Worcester, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: McDermott
authors.forename: M C
authors.initials: MC
authors.lastname: Regan
authors.forename: R
authors.initials: R
authors.lastname: Page
authors.forename: M A
authors.initials: MA
authors.lastname: Stokes
authors.forename: K
authors.initials: K
authors.lastname: Barry
authors.forename: D C
authors.initials: DC
authors.lastname: Moriarty
authors.forename: P F
authors.initials: PF
authors.lastname: Caushaj
authors.forename: J M
authors.initials: JM
authors.lastname: Fitzpatrick
authors.forename: T F
authors.initials: TF
authors.lastname: Gorey
mesh_terms: D000818:Animals; D006439:Hemodynamics; D010535:Laparoscopy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D011659:Pulmonary Gas Exchange; D011897:Random Allocation; D013552:Swine; D014692:Ventilation-Perfusion Ratio