Open AccessInfluence of laparoscopic carbon dioxide pneumoperitoneum on neonate circulation and respiration
Author(s) -
Liwei Li,
Wei Zhang,
Yanqiu Ai,
Li Li,
Peng Zhouquan,
Hongwei Wang
Publication year - 2013
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/0300060513481922
Subject(s) - pneumoperitoneum , medicine , exsufflation , insufflation , anesthesia , respiration , oxygen saturation , carbon dioxide , blood pressure , arterial blood , oxygen , surgery , laparoscopy , chemistry , anatomy , organic chemistry
Objective This study investigated the influence of laparoscopic carbon dioxide (CO 2 ) pneumoperitoneum on neonate circulation and respiration.Methods The study included neonates undergoing elective laparoscopic abdominal surgery. CO 2 insufflation pressure was maintained within 8–14 mmHg for pneumoperitoneum creation. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO 2 ), partial pressure of end-tidal carbon dioxide ( P ET CO 2 ) and maximum inspiratory pressure were monitored continuously. Arterial blood samples were collected: 5 min before pneumoperitoneum creation (baseline); 5, 10, and 20 min after CO 2 insufflation; 10 min after CO 2 exsufflation; 10 min after surgery. pH, partial pressure of CO 2 (PaCO 2 ) and arterial oxygen saturation (SaO 2 ) were also measured.Results Thirty-six neonates were included. HR and MAP significantly increased after pneumoperitoneum creation, then decreased to baseline after CO 2 exsufflation. PaCO 2 and P ET CO 2 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 SpO 2 and SaO 2 .Conclusion CO 2 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.