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Study of Venous Blood Flow Changes During Laparoscopic Surgery Using a Thermodilution Technique
Author(s) -
Marshall N. J.,
Bessell J. R.,
Maddern G. J.
Publication year - 2000
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1046/j.1440-1622.2000.01917.x
Subject(s) - medicine , venous stasis , venous return curve , femoral vein , trendelenburg position , blood flow , pneumoperitoneum , hemodynamics , laparoscopic surgery , anesthesia , trendelenburg , venous thrombosis , surgery , deep vein , intermittent pneumatic compression , vein , thrombosis , laparoscopy , cardiology
Background : Many modalities exist to analyse those factors that contribute to venous stasis and deep venous thrombosis (DVT) during laparoscopic surgery. To the authors’ knowledge intraoperative measurement of femoral venous blood flow has not yet been performed nor has the influence of sequential compression devices been assessed using this parameter. Methods : The thermodilution technique similar to that employed in cardiac output measurement was used to determine changes in blood flow in the right femoral vein during laparoscopic cholecystectomy. Deep venous thrombosis prophylaxis involved peri‐ operative use of sequential compression devices and subcutaneous heparin 5000 U. Results : Pneumoperitoneum and the Trendelenburg position reduced femoral venous return in four of the six patients studied, but sequential compression devices failed to return blood flow to baseline in a predictable fashion. Conclusions : Although the measurement of blood flow using thermodilution is regarded as a reliable technique, during general anaesthesia the results may be susceptible to haemodynamic variations related to the anaesthetic agents as well as to the laparoscopic procedure. In addition sequential compression devices (when used alone) may not provide adequate prophylaxis against DVT because they do not predictably increase femoral blood flow.