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Effects of pneumoperitoneum on splanchnic hemodynamics: an experimental study in pigs
I B Rasmussen1, U Berggren, D Arvidsson
1Department of Surgery, University Hospital, Uppsala, Sweden.
Objective:
To study the effects on splanchnic haemodynamics of pneumoperitoneum induced by carbon dioxide insufflation.
Design:
Controlled experimental study.
Animals:
11 Pigs weighing 19-30 kg.
Intervention:
The animals were divided into a control group (n = 4) and a experimental group (n = 7). Experimental animals were subjected to stepwise increasing intra-abdominal pressure from 0 mm Hg to 25 mm Hg by carbon dioxide insufflation.
Main Outcome Measures:
Portal venous blood flow, portal venous blood pressure, portal/hepatic vascular resistance, and gastrointestinal vascular resistance.
Results:
At 25 mm Hg portal venous blood flow was reduced (66% of baseline), and portal venous blood pressure and portal/hepatic vascular resistance were increased (360% and 650% of baseline, respectively). The increase in gastrointestinal vascular resistance was less pronounced.
Conclusions:
Increased intra-abdominal pressure caused significant changes in the splanchnic haemodynamics. The risk was greater if the intra-abdominal pressure exceeded 15 mm Hg.