Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure

Eric J. Kraut, John T. Anderson, Amira Safwat, Ronald Barbosa, Bruce Wolfe

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: The cardiopulmonary effects of the combination of abdominal and thoracic pressures in humans have not been well delineated. Objective: To study the cardiopulmonary effects of 15 mm Hg of intra-abdominal pressure in the presence and absence of 10 cm H2O of positive end-expiratory pressure (PEEP). Design: Prospective. Setting: University hospital. Methods: Nine patients undergoing laparoscopic cholecystectomy had pulmonary compliance, cardiac output, exhaled carbon dioxide, and preload (left ventricular end- diastolic volume) determined at 4 points while undergoing ventilation with (1) no PEEP before pneumoperitoneum; (2) 10 cm H2O of PEEP and no pneumoperitoneum; (3) no PEEP and 15 mm Hg of pneumoperitoneum; and (4) 10 cm H2O of PEEP and 15 mm Hg of pneumoperitoneum. Preload and cardiac output were determined by means of transesophageal echocardiography. Pulmonary compliance and exhaled carbon dioxide were determined by an attachment to the end of the endotracheal tube. Main Outcome Measures: Preload, cardiac output, exhaled carbon dioxide, and pulmonary compliance. Results: There was no significant change from baseline in preload, cardiac output, or pulmonary compliance when either PEEP or pneumoperitoneum was applied separately. However, there was a significant decrease in preload (P2O of PEEP. This combination of pressures may pose a contraindication to laparoscopic surgery.

Original languageEnglish (US)
Pages (from-to)76-80
Number of pages5
JournalArchives of Surgery
Volume134
Issue number1
DOIs
StatePublished - Jan 1999
Externally publishedYes

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Positive-Pressure Respiration
Laparoscopy
Pneumoperitoneum
Lung Compliance
Cardiac Output
Carbon Dioxide
Pressure
Laparoscopic Cholecystectomy
Transesophageal Echocardiography
Stroke Volume
Ventilation
Thorax
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure. / Kraut, Eric J.; Anderson, John T.; Safwat, Amira; Barbosa, Ronald; Wolfe, Bruce.

In: Archives of Surgery, Vol. 134, No. 1, 01.1999, p. 76-80.

Research output: Contribution to journalArticle

Kraut, Eric J. ; Anderson, John T. ; Safwat, Amira ; Barbosa, Ronald ; Wolfe, Bruce. / Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure. In: Archives of Surgery. 1999 ; Vol. 134, No. 1. pp. 76-80.
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