title: Laparoscopic pneumoperitoneum in acute peritonitis does not increase bacteremia or aggravate metabolic or hemodynamic disturbances.
abstract: The use of laparoscopy in generalized peritonitis has become increasingly frequent in recent years. However, CO2 pneumoperitoneum in association with increased intraperitoneal pressure may have deleterious effects in patients with hemodynamic or metabolic disturbances caused by bacterial peritonitis. The purpose of this study was to investigate the effect of CO2 pneumoperitoneum on bacteremia, mean arterial pressure, and blood gas disturbances in an animal model of bacterial peritonitis. Dogs were anesthetized, orally intubated, and subjected to experimental peritonitis by intraperitoneal inoculation of a suspension containing Escherichia coli and sterile dog feces. The animals were randomly assigned to two groups: control animals were maintained under anesthesia, and the insufflated animals were subjected to intraperitoneal CO2 insufflation. Bacterial peritonitis provoked the appearance of bacteremia and a significant decrease in mean arterial pressure, pH, bicarbonate, and base deficit. The induction of bacterial peritonitis did not significantly influence pH in the control group and partial pressure of arterial CO2 in either group. Thirty minutes of CO2 pneumoperitoneum did not influence the effect of bacterial peritonitis on the analyzed variables. These results suggest that laparoscopic CO2 pneumoperitoneum does not aggravate bacteremia or metabolic and hemodynamic disturbances induced by bacterial peritonitis.
authors.affiliation: University of São Paulo School of Medicine, Department of Surgery, São Paulo, Brazil.
authors.forename: F D
authors.initials: FD
authors.lastname: Collet e Silva
authors.forename: R C
authors.initials: RC
authors.lastname: Ramos
authors.forename: L F
authors.initials: LF
authors.lastname: Zantut
authors.forename: R S
authors.initials: RS
authors.lastname: Poggetti
authors.forename: B
authors.initials: B
authors.lastname: Fontes
authors.forename: D
authors.initials: D
authors.lastname: Birolini
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000209:etiology*; D002245:Carbon Dioxide; D004195:Disease Models, Animal; D004285:Dogs; D006439:Hemodynamics; D008297:Male; D010538:Peritonitis / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial; D011897:Random Allocation
chemical_list: D002245:Carbon Dioxide