title: Transoesophageal echocardiographic assessment of haemodynamic function during laparoscopic cholecystectomy.
abstract: We have measured cardiovascular changes associated with insufflation of carbon dioxide and the reverse Trendelenburg position during laparoscopic cholecystectomy, using transoesophageal echocardiography in 13 healthy patients. End-tidal carbon dioxide values increased after insufflation of carbon dioxide, with values significantly (P < 0.05) increased after lateral tilt positioning. Creation of a pneumoperitoneum was associated with increases (P < 0.05) in left ventricular end-systolic wall stress, concomitant with increases (P < 0.01) in peak airway pressure and systemic arterial pressure. In addition, left ventricular end-diastolic area decreased (P < 0.05) after reverse Trendelenburg positioning. Left ventricular ejection fraction was maintained throughout the study.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510.
authors.forename: A J
authors.initials: AJ
authors.lastname: Cunningham
authors.forename: J
authors.initials: J
authors.lastname: Turner
authors.forename: S
authors.initials: S
authors.lastname: Rosenbaum
authors.forename: T
authors.initials: T
authors.lastname: Rafferty
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000502:physiology; D017081:Cholecystectomy, Laparoscopic; D004452:Echocardiography; D004947:Esophagus; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D002245:Carbon Dioxide