Effects of carbon dioxide pneumoperitoneum on hemodynamics in cirrhotic rats.
BACKGROUND
The aim of our study was to investigate the effect of carbon dioxide pneumoperitoneum on systemic and splanchnic hemodynamics in cirrhotic rats.


METHODS
Sprague-Dawley rats (n = 80) were used in this study. Liver cirrhosis was induced by thioacetamide administration intraperitoneally (200 mg/kg body weight, twice a week for 16 weeks). The radioactive microsphere method was used to measure systemic and regional hemodynamic parameters before, 1 h after the start, and 1 h after the release of pneumoperitoneum.


RESULTS
Splanchnic blood flow and cardiac index were significantly depressed during pneumoperitoneum in liver cirrhosis and control groups, but no significant differences were seen between the two groups. In both groups, portal venous inflow decreased and hepatic arterial blood flow increased significantly during pneumoperitoneum. However, during pneumoperitoneum, total hepatic blood flow as a percentage of its value before pneumoperitoneum was lower in cirrhotic rats (71.0%) than in control rats (91.9%) (p <0.05, Mann-Whitney U-test).


CONCLUSIONS
Carbon dioxide pneumoperitoneum markedly decreases total hepatic blood flow in cirrhotic rats due to the impaired hepatic arterial buffer response. Liver function should be carefully controlled in cirrhotic patients after laparoscopic surgery with pneumoperitoneum.
Tsuboi
S
S
First Department of Surgery, Oita Medical University, Oita 879-5593, Japan.
Kitano
S
S
Yoshida
T
T
Bandoh
T
T
Ninomiya
K
K
Baatar
D
D
D000818:Animals; D001794:Blood Pressure; D002245:Carbon Dioxide; D006339:Heart Rate; D006439:Hemodynamics; D010535:Laparoscopy / Q000009:adverse effects*; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011169:Portal Vein / Q000503:physiopathology; D051381:Rats; D011919:Rats, Inbred Strains; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow; D013152:Splanchnic Circulation; D013853:Thioacetamide
D013853:Thioacetamide; D002245:Carbon Dioxide