Related Experiment Video

Updated: Mar 19, 2026

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Published on: September 6, 2024

Pneumoperitoneum deteriorates intratidal respiratory system mechanics: an observational study in lung-healthy

Steffen Wirth¹, Andreas Biesemann², Johannes Spaeth²

¹Department of Anesthesiology and Critical Care, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. steffen.wirth@uniklinik-freiburg.de.

Surgical Endoscopy

|June 22, 2016

Abstract

Background:

Pneumoperitoneum during laparoscopic surgery leads to atelectasis and impairment of oxygenation. Positive end-expiratory pressure (PEEP) is supposed to counteract atelectasis. We hypothesized that the derecruiting effects of pneumoperitoneum would deteriorate the intratidal compliance profile in patients undergoing laparoscopic surgery.

Methods:

In 30 adult patients scheduled for surgery with pneumoperitoneum, respiratory variables were measured during mechanical ventilation. We calculated the dynamic compliance of the respiratory system (C _RS) and the intratidal volume-dependent C _RS curve using the gliding-SLICE method. The C _RS curve was then classified in terms of indicating intratidal recruitment/derecruitment (increasing profile) and overdistension (decreasing profile). During the surgical interventions, the PEEP level was maintained nearly constant at 7 cm H₂O. Data are expressed as mean [confidence interval].

Results:

Baseline C _RS was 60 [54-67] mL cm H₂O^-1. Application of pneumoperitoneum decreased C _RS to 40 [37-43] mL cm H₂O^-1 which partially recovered to 54 [50-59] mL cm H₂O^-1 (P < 0.001) after removal but remained below the value measured before pneumoperitoneum (P < 0.001). Baseline compliance profiles indicated intratidal recruitment/derecruitment in 48 % patients. After induction of pneumoperitoneum, intratidal recruitment/derecruitment was indicated in 93 % patients (P < 0.01), and after removal intratidal recruitment/derecruitment was indicated in 59 % patients. Compliance profiles showing overdistension were not observed.

Conclusions:

Analyses of the intratidal compliance profiles reveal that pneumoperitoneum during laparoscopic surgery causes intratidal recruitment/derecruitment which partly persists after its removal. The analysis of the intratidal volume-dependent C _RS profiles could be used to guide intraoperative PEEP adjustments during elevated intraabdominal pressure.

Keywords:

Compliance–volume curve Lung compliance Mechanical ventilation Pneumoperitoneum Protective ventilation Respiratory system mechanics

More Related Videos

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics

Published on: April 19, 2024

Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia

Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia

Published on: May 6, 2014

Related Concept Videos

Pressure Relationships in Thoracic Cavity

Pressure Relationships in Thoracic Cavity

Breathing, otherwise known as pulmonary ventilation, is the process of air movement into and out of the lungs. The main mechanisms propelling pulmonary ventilation are atmospheric pressure (Patm), intra-pulmonary (Ppul ) or intra-alveolar pressure (Palv) within the alveoli, and intrapleural pressure (Pip) within the pleural cavity.
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...

Pneumothorax-II

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:

Pulmonary Ventilation: Inhalation

Pulmonary Ventilation: Inhalation

Pulmonary ventilation is a vital process that ensures the exchange of oxygen and carbon dioxide in the lungs. It refers to the movement of air into and out of the lungs, enabling the body to obtain oxygen and remove waste carbon dioxide. In this article, we will explore the intricacies of pulmonary ventilation, including its underlying principles, mechanisms, and the interplay of pressures within the respiratory system.
Boyle's law becomes particularly pertinent when examining respiratory...

Pneumothorax-I

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.

Pulmonary Cycle: Exhalation

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...

Respiratory System Abnormal Finding I: Inspection and Percussion

Respiratory System Abnormal Finding I: Inspection and Percussion

Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...

Articles linked to this work by shared authors, journal, and citation graph.

Design and development of a novel media-separated valve for flow-controlled expiration during mechanical ventilation.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine·2026

Evaluation of the effect of a long inspiratory ramp time during pressure-controlled ventilation with volume guarantee: study protocol for a randomized, controlled trial.

Trials·2026

Dislodgement forces and cost effectiveness of prehospital securement of peripheral intravenous catheters on moist skin: a randomized controlled clinical trial in healthy volunteers.

European journal of trauma and emergency surgery : official publication of the European Trauma Society·2026

A ventilatable physical four compartment model of the rat thorax for electrical impedance tomography.

Physiological measurement·2026

Anesthesia Workstation Performance in Pediatric Ventilation: Part 2. Characteristics during Pressure Support Ventilation and Oxygen Rise Times.

Anesthesiology·2026

Anesthesia Workstation Performance in Pediatric Ventilation: Part 1. Precision of Ventilation.

Anesthesiology·2026

See all related articles