Comparison of the effects of carbon dioxide and helium pneumoperitoneum on renal function.
OBJECTIVE
Carbon dioxide pneumoperitoneum is associated with significant hypercarbia and acidosis. The aim of this study is to evaluate the effects of carbon dioxide and helium pneumoperitoneum on renal function.


METHODS
Thirty adult dogs were put randomly into one of three groups (n=10 animals each): group A--pneumoperitoneum not performed; group B--CO(2) pneumoperitoneum; and group C--helium pneumoperitoneum. The groups were analyzed with consideration given to body weight, hematologic values, hemodynamic parameters (heart rate, mean arterial pressure, central venous pressure, cardiac output, stroke volume, systemic vascular resistance, pulmonary vascular resistance, left cardiac work index, cardiac index, mean pulmonary artery pressure, and pulmonary capillary wedge pressure), and renal function (plasma renin activity, urinary output, creatinine clearance, and sodium excretory fraction).


RESULTS
An accentuated decrease in urinary output was observed during pneumoperitoneum in groups B and C compared to the control group. In groups B and C, creatinine clearance declined significantly during pneumoperitoneum in comparison to group A, but after deflation a faster recovery of glomerular filtration was noticed for group C, and a significant increase in sodium excretory fraction was seen for group B. On the other hand, in comparison to the control group, group B had a significant increase in plasma renin activity, with late recovery of glomerular function.


CONCLUSIONS
Helium ameliorates renal alterations when used for pneumoperitoneum, and it might be used for patients with compromised renal function who have to undergo laparoscopic surgery.
Carmona
Murilo
M
Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
Lopes
Roberto Iglesias
RI
Borba
Marcelo
M
Omokawa
Maurício
M
Naufal
Rafael
R
Miyaji
Karina
K
Matsumura
Norio
N
Vieira
Newton
N
Pereira
Paulo Roberto Bueno
PR
D000818:Animals; D001794:Blood Pressure; D002245:Carbon Dioxide; D002302:Cardiac Output; D003404:Creatinine / Q000652:urine; D004285:Dogs; D005919:Glomerular Filtration Rate; D006371:Helium; D006863:Hydrogen-Ion Concentration; D011028:Pneumoperitoneum, Artificial; D011897:Random Allocation; D012083:Renin / Q000097:blood; D012964:Sodium / Q000652:urine; D014556:Urine
D002245:Carbon Dioxide; D006371:Helium; D012964:Sodium; D003404:Creatinine; D012083:Renin