Alterations in hemodynamics and left ventricular contractility during carbon dioxide pneumoperitoneum.

Published

Journal Article

BACKGROUND: Carbon dioxide (CO2) pneumoperitoneum has been shown to adversely affect hemodynamics in patients. This study specifically examines the potential contribution of altered left ventricular contractility (LVC) to hemodynamic changes observed during CO2 pneumoperitoneum. METHODS: In a canine model, LV volumes, LV pressure, and intrathoracic and central venous pressures were recorded both at basal intra-abdominal pressure (IAP) and after CO2 insufflation to produce IAPs of 5-25 mmHg. RESULTS: At IAPs greater than 15 mmHg, cardiac output and LV end-diastolic volume decreased. Mean arterial pressure and heart rate were unchanged. LVC, quantified using the linear Frank-Starling relationship, was not affected by increases in IAP. CONCLUSIONS: This study is the first to quantify LVC during CO2 pneumoperitoneum and demonstrates no changes in contractility over IAPs from 5 to 25 mmHg. In the dog model, any hemodynamic alterations induced by CO2 pneumoperitoneum are secondary to altered LV preload and not alterations in contractility or LV afterload.

Full Text

Duke Authors

Cited Authors

  • Marathe, US; Lilly, RE; Silvestry, SC; Schauer, PR; Davis, JW; Pappas, TN; Glower, DD

Published Date

  • October 1996

Published In

Volume / Issue

  • 10 / 10

Start / End Page

  • 974 - 978

PubMed ID

  • 8864088

Pubmed Central ID

  • 8864088

Electronic International Standard Serial Number (EISSN)

  • 1432-2218

International Standard Serial Number (ISSN)

  • 0930-2794

Digital Object Identifier (DOI)

  • 10.1007/s004649900217

Language

  • eng