Open AccessHemodynamic Response to Thoracoscopy and Thoracotomy
Author(s) -
S Trča,
Z Krška,
O Kittnar,
Mikuláš Mlček,
R Demes,
Vilém Danzig,
Stanislav Šimek,
Jan Bruthans,
R Frasko
Publication year - 2010
Publication title -
physiological research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 70
eISSN - 1802-9973
pISSN - 0862-8408
DOI - 10.33549/physiolres.931750
Subject(s) - medicine , hemodynamics , thoracoscopy , central venous pressure , pulmonary wedge pressure , anesthesia , blood pressure , thoracotomy , cardiac output , pulmonary artery , cardiology , surgery , heart rate
Operations in the pleural cavity are connected with circulatorychanges in pulmonary circulation and general changes ofhemodynamics. These changes are influenced by the position ofpatient’s body on the operation table and by the introduction ofartificial pneumothorax. Thoracoscopy is an advanced surgicalapproach in thoracic surgery, but its hemodynamic effect is stillnot known. The aim of the present study was to compare thehemodynamic response to surgeries carried out by open(thoracotomy – TT) and closed (thoracoscopy – TS) surgicalapproach. Thirty-eight patients have been monitored throughoutthe operation – from the introduction of anesthesia to completingthe surgery. Monitored parameters were systolic blood pressure(BPs), diastolic blood pressure (BPd), O2 saturation (SaO2),systolic blood pressure in pulmonary artery (BPPAs), diastolicblood pressure in pulmonary artery (BPPAd), wedge pressure(PW), central venous pressure in right atrium (CVP), cardiacoutput (CO) and total peripheral resistance (TPR). No significantdifference has been found in hemodynamic response between TTand TS groups. Significant changes of hemodynamic parametersoccurring during the whole surgical procedure were detected inboth technical approaches. The most prominent changes werefound after the position of patients was changed to the hipposition (significantly decreased BPs, BPd, MAP, SaO2 and BPPAs)and 5 min after the pneumothorax was established (restorationof the cardiac output to the initial value and significant decreaseof the TPR). It can be concluded that the thoracoscopy causesalmost identical hemodynamic changes like the thoracotomy.