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Gewählte Publikation:

Schmedt, CG; Heupel, O; Riemer, V; Gutt, CN.
Insufflation profile and body position influence portal venous blood flow during pneumoperitoneum
SURG ENDOSC. 2003; 17(12): 1951-1957. Doi: 10.1007/s00464-002-9244-5
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Co-Autor*innen der Med Uni Graz
Schemmer Peter
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Abstract:
We investigated changes in portal venous blood flow (PVBF) during carbon dioxide (CO2) pneumoperitoneum to evaluate the effects of different insufflation profiles and body positions. An established rat model was extended by implanting a portal vein flow probe that would enable us to measure PVBF for 60 min [t0-t60] in animals subjected to a CO2 pneumoperitoneum with an intraabdominal pressure (IAP) of 9 mmHg. Forty-eight male Sprague-Dawley rats were randomized into the following four experimental and two control groups: decompression group D1 ( n = 8), desufflation for 1 min every 14 min; decompression group D2 ( n = 8), desufflation for 5 min, after 27 min; position group P1 ( n = 8), 35 degrees head-up position; position group P2 ( n = 8), 35 degrees head-down position; negative control group C1 ( n = 8), no insufflation; positive control group C2 ( n = 8), constant IAP of 9 mmHg for 60 min. Pneumoperitoneum and body positions, respectively, reduced PVBF [t1-t60] significantly ( p < 0.001) by 32.0% C2, 32.8% D1, 31.1% D2, 40.8% P1, and 48.5% P2, as compared to PVBF at t0 in each group. There was a significant difference in PVBF reduction between P1 and P2 and also between C2 and both P1 and P2 ( p < 0.04). CO2 pneumoperitoneum reduces PVBF significantly (>30%). Extreme body positions (35 degrees tilt) significantly intensify PVBF reduction. PVBF reduction is significantly more dramatic in subjects placed in a 35 degrees head-down position. Short desufflation periods did not improve mean PVBF, but it may have beneficial immunological and oncological effects that warrant further investigation.
Find related publications in this database (using NLM MeSH Indexing)
Animals -
Carbon Dioxide -
Head-Down Tilt - adverse effects
Insufflation -
Intraoperative Complications - etiology
Intraoperative Complications - prevention & control
Ischemia - etiology
Ischemia - prevention & control
Liver - blood supply
Liver - physiopathology
Liver Circulation -
Male -
Pneumoperitoneum, Artificial - adverse effects
Pneumoperitoneum, Artificial - methods
Portal System - physiopathology
Portal Vein -
Pressure -
Random Allocation -
Rats -
Rats, Sprague-Dawley -
Supine Position -

Find related publications in this database (Keywords)
portal venous blood flow
pneumoperitoneum
body position
rat model
laparoscopic surgery
desufflation
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