Pneumoperitoneum risk prognosis and correction of venous circulation disturbances in laparoscopic surgery
| Autor: | S. I. Emeljanov, N L Matveev, S. R. Musaeva, V. V. Fedenko, S. V. Luosev, V. V. Evdoshenko, A. V. Fedorov, V. V. Bokarev, I. G. Bobrinskaya, E. M. Levite, S. A. Panfilov |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Hemodynamics Pilot Projects Risk Assessment Veins Pneumoperitoneum Reference Values medicine Humans Cardiac Output skin and connective tissue diseases Vein Laparoscopy Lung Aged Aged 80 and over Leg medicine.diagnostic_test business.industry Middle Aged Prognosis medicine.disease Respiratory Function Tests Surgery Endoscopy body regions medicine.anatomical_structure Cholecystectomy Laparoscopic Regional Blood Flow Anesthesia Female Cholecystectomy sense organs business Pneumoperitoneum Artificial Compliance Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 12:1224-1231 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | This study was initiated to find a method of determining the prognosis for possible changes in hemodynamic and respiratory parameters in patients with pneumoperitoneum (PP).We devised a model for a pseudopneumoperitoneum (PPP), which is created by encircling the wide pneumochamber on the entire abdomen and inflating it to a preset pressure. To verify the prognostic possibilities of the proposed model, we studied the pneumotachygraphy parameters, noninvasive and invasive monitoring parameters of PPP after induction of anaesthesia, and venous circulation disturbances, as well as the medical effect of the intermittent sequential compression device.In healthy patients, the restrictive lung syndrome did not approach the risky limit. In patients/=60 years old, this syndrome was very close to the limit. In a number of patients with serious cardiovascular and pulmonary pathology, the pressure of10 mmHg was considered to be intolerable. Lung compliance, which was the parameter most sensitive to the increased intraabdominal pressure, was 47 +/- 10 at baseline, and 29 +/- 4 (p0.05) at both PPP and real PP (14 mmHg).The PPP model is quite similar to the real PP and can be used for preoperative prognosis in laparoscopic surgery. The elevated intraabdominal pressure results in a significant disturbance of venous blood flow in the lower extremities. The use of the device for peristaltic pneumomassage of the lower limbs is effective in correcting negative changes in venous hemodynamics in laparoscopic surgery. |
| Databáze: | OpenAIRE |
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