title: Comparison of the effects of carbon dioxide and helium pneumoperitoneum on renal function.
abstract: 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.
authors.affiliation: Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Murilo
authors.initials: M
authors.lastname: Carmona
authors.forename: Roberto Iglesias
authors.initials: RI
authors.lastname: Lopes
authors.forename: Marcelo
authors.initials: M
authors.lastname: Borba
authors.forename: Maurício
authors.initials: M
authors.lastname: Omokawa
authors.forename: Rafael
authors.initials: R
authors.lastname: Naufal
authors.forename: Karina
authors.initials: K
authors.lastname: Miyaji
authors.forename: Norio
authors.initials: N
authors.lastname: Matsumura
authors.forename: Newton
authors.initials: N
authors.lastname: Vieira
authors.forename: Paulo Roberto Bueno
authors.initials: PR
authors.lastname: Pereira
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide; D006371:Helium; D012964:Sodium; D003404:Creatinine; D012083:Renin