title: Influence of laparoscopic carbon dioxide pneumoperitoneum on neonate circulation and respiration.
abstract: OBJECTIVE
  This study investigated the influence of laparoscopic carbon dioxide (CO2) pneumoperitoneum on neonate circulation and respiration.
  
  
  METHODS
  The study included neonates undergoing elective laparoscopic abdominal surgery. CO2 insufflation pressure was maintained within 8-14 mmHg for pneumoperitoneum creation. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (P ETCO2) and maximum inspiratory pressure were monitored continuously. Arterial blood samples were collected: 5 min before pneumoperitoneum creation (baseline); 5, 10, and 20 min after CO2 insufflation; 10 min after CO2 exsufflation; 10 min after surgery. pH, partial pressure of CO2 (PaCO2) and arterial oxygen saturation (SaO2) were also measured.
  
  
  RESULTS
  Thirty-six neonates were included. HR and MAP significantly increased after pneumoperitoneum creation, then decreased to baseline after CO2 exsufflation. PaCO2 and P ETCO2 were significantly higher after pneumoperitoneum creation, whereas pH was significantly lower 20 min after pneumoperitoneum creation compared with baseline. No significant differences were observed in SpO2 and SaO2.
  
  
  CONCLUSIONS
  CO2 pneumoperitoneum had a significant effect on neonatal circulation and respiration, suggesting that the pneumoperitoneal pressure should be limited within a certain range in neonates undergoing laparoscopic surgery.
authors.affiliation: Department of Anaesthesiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Yan-Qiu
authors.initials: YQ
authors.lastname: Ai
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Zhou-Quan
authors.initials: ZQ
authors.lastname: Peng
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Wang
mesh_terms: D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001775:Blood Circulation / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000494:pharmacology*; D017558:Elective Surgical Procedures; D016099:Endoscopy, Gastrointestinal; D006339:Heart Rate / Q000187:drug effects; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007327:Insufflation / Q000379:methods; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D046248:Pyloric Stenosis, Hypertrophic / Q000601:surgery*; D012119:Respiration / Q000187:drug effects*
chemical_list: D018686:Anesthetics, Intravenous; D002245:Carbon Dioxide
keywords: Neonate; circulation; laparoscopy; respiration