Skip to main content
SpringerLink
Log in

Pneumoperitoneum affects stroke volume variation in humans

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Purpose

Stroke volume variation (SVV) is affected by many factors. Although elevated intra-abdominal pressure and a pneumoperitoneum have been shown to increase SVV in animals, a recent human study showed that SVV did not change as a pneumoperitoneum was established. However, we considered the results of this study questionable, and we therefore attempted to study whether SVV changes both before and after pneumoperitoneums in humans.

Methods

We performed a prospective observational study in 19 patients undergoing cholecystectomy or colectomy while on mechanical ventilation. Immediately before pneumoperitoneum, baseline registrations of variables were obtained (baseline I), which were measured every min for 5 min after the pneumoperitoneum was initiated. Immediately before the pneumoperitoneum was released, another baseline registration of variables was obtained (baseline II); these variables were then measured every min for 5 min.

Results

After the pneumoperitoneum was initiated, there were significant increases in SVV at the 2- to 5-min time points. After release of the pneumoperitoneum, there were significant decreases in SVV at the 1- to 5-min time points.

Conclusion

A pneumoperitoneum increased SVV, which is similar to the findings of previous animal studies but is different from a previous clinical study. Upon release of the pneumoperitoneum, SVV decreased significantly, which is new information. SVV values must be estimated cautiously during a pneumoperitoneum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Zhang Z, Lu B, Sheng X, Jin N. Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis. J Anesth. 2011;25:904–16.

    Article  PubMed  Google Scholar 

  2. Wajima Z, Shiga T, Imanaga K, Inoue T. Assessment of the effect of rapid crystalloid infusion on stroke volume variation and pleth variability index after a preoperative fast. J Clin Monit Comput. 2010;24:385–9.

    Article  PubMed  Google Scholar 

  3. Wajima Z, Shiga T, Imanaga K, Inoue T. Do induced hypertension and hypotension affect stroke volume variation in man? J Clin Anesth. 2012;24:207–11.

    Article  PubMed  Google Scholar 

  4. Wajima Z, Shiga T, Imanaga K, Inoue T. Does intravenous landiolol, a β1-adrenergic blocker, affect stroke volume variation? J Anesth. 2013;27:890–4.

    Article  PubMed  Google Scholar 

  5. Wajima Z, Tsuchida H, Shiga T, Imanaga K, Inoue T. Intravenous landiolol, a novel β1-adrenergic blocker, reduces the minimum alveolar concentration of sevoflurane in women. J Clin Anesth. 2011;23:292–6.

    Article  CAS  PubMed  Google Scholar 

  6. Biais M, Nouette-Gaulain K, Cottenceau V, Revel P, Sztark F. Uncalibrated pulse contour-derived stroke volume variation predicts fluid responsiveness in mechanically ventilated patients undergoing liver transplantation. Br J Anaesth. 2008;101:761–8.

    Article  CAS  PubMed  Google Scholar 

  7. De Backer D, Heenen S, Piagnerelli M, Koch M, Vincent J-L. Pulse pressure variations to predict fluid responsiveness: influence of tidal volume. Intensive Care Med. 2005;31:517–23.

    Article  PubMed  Google Scholar 

  8. Reuter DA, Bayerlein J, Goepfert MS, Weis FC, Kilger E, Lamm P, Goetz AE. Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients. Intensive Care Med. 2003;29:476–80.

    PubMed  Google Scholar 

  9. Duperret S, Lhuillier F, Piriou V, Vivier E, Metton O, Branche P, Annat G, Bendjelid K, Viale JP. Increased intra-abdominal pressure affects respiratory variations in arterial pressure in normovolaemic and hypovolaemic mechanically ventilated healthy pigs. Intensive Care Med. 2007;33:163–71.

    Article  PubMed  Google Scholar 

  10. Jacques D, Bendjelid K, Duperret S, Colling J, Piriou V, Viale JP. Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure: an experimental study. Crit Care. 2011;15:R33.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Renner J, Gruenewald M, Quaden R, Hanss R, Meybohm P, Steinfath M, Scholz J, Bein B. Influence of increased intra-abdominal pressure on fluid responsiveness predicted by pulse pressure variation and stroke volume variation in a porcine model. Crit Care Med. 2009;37:650–8.

    Article  PubMed  Google Scholar 

  12. Valenza F, Chevallard G, Porro GA, Gattinoni L. Static and dynamic components of esophageal and central venous pressure during intra-abdominal hypertension. Crit Care Med. 2007;35:1575–81.

    Article  PubMed  Google Scholar 

  13. Høiseth LØ, Hoff IE, Myre K, Landsverk SA, Kirkeboen KA. Dynamic variables of fluid responsiveness during pneumoperitoneum and laparoscopic surgery. Acta Anaesthesiol Scand. 2012;56:777–86.

    Article  PubMed  Google Scholar 

  14. Wajima Z, Shitara T, Ishikawa G, Kaneko K, Inoue T, Ogawa R. Analgesia after upper abdominal surgery using extradural administration of a fixed dose of buprenorphine in combination with lignocaine given at two infusion rates: a comparative study. Acta Anaesthesiol Scand. 1997;41:1061–5.

    Article  CAS  PubMed  Google Scholar 

  15. Wajima Z, Shitara T, Ishikawa G, Inoue T, Ogawa R. Analgesia after upper abdominal surgery with extradural buprenorphine with lidocaine. Can J Anaesth. 1998;45:28–33.

    Article  CAS  PubMed  Google Scholar 

  16. Biais M, Vidil L, Sarrabay P, Cottenceau V, Revel P, Sztark F. Changes in stroke volume induced by passive leg raising in spontaneously breathing patients: comparison between echocardiography and Vigileo/FloTrac device. Crit Care. 2009;13:R195.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Haljamäe H. Rules of thumb. In: Hahn RG, editor. Clinical fluid therapy in the perioperative. setting ed. Cambridge: Cambridge University Press; 2011. p. 18–28.

    Chapter  Google Scholar 

  18. Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37:2642–7.

    Article  PubMed  Google Scholar 

  19. Tournadre JP, Allaouchiche B, Cayrel V, Mathon L, Chassard D. Estimation of cardiac preload changes by systolic pressure variation in pigs undergoing pneumoperitoneum. Acta Anaesthesiol Scand. 2000;44:231–5.

    Article  CAS  PubMed  Google Scholar 

  20. Bliacheriene F, Machado SB, Fonseca EB, Otsuke D, Auler JO Jr, Michard F. Pulse pressure variation as a tool to detect hypovolaemia during pneumoperitoneum. Acta Anaesthesiol Scand. 2007;51:1268–72.

    CAS  PubMed  Google Scholar 

  21. Malbrain ML, de Laet I. Functional hemodynamics and increased intra-abdominal pressure: same thresholds for different conditions…? Crit Care Med. 2009;37:781–3.

    Article  PubMed  Google Scholar 

  22. Shibutani K, Muraoka M, Shirasaki S, Kubal K, Sanchala VT, Gupte P. Do changes in end-tidal PCO2 quantitatively reflect changes in cardiac output? Anesth Analg. 1994;79:829–33.

    Article  CAS  PubMed  Google Scholar 

  23. Donati A, Munch C, Marini B, Orsetti G, Coltrinari R, Pietropaoli P. Transesophageal Doppler ultrasonography evaluation of hemodynamic changes during videolaparoscopic cholecystectomy. Minerva Anestesiol. 2002;68:549–54.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was conducted in the Department of Anesthesiology, International University of Health and Welfare Shioya Hospital, Tochigi, Japan. This study was supported solely by departmental resources.

Conflict of interest

No author declares any conflicts of interest.

Author information

Author notes

  1. Kazuyuki Imanaga

    Present address: Department of Anesthesia, Ishikawajima Memorial Hospital, 2-5-17 Tsukuda, Chuo-ku, Tokyo, 104-0051, Japan

Authors and Affiliations

  1. Department of Anesthesiology, International University of Health and Welfare Shioya Hospital, 77 Tomita, Yaita, Tochigi, 329-2145, Japan

    Zen’ichiro Wajima

  2. Department of Anesthesiology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasu-shiobara, Tochigi, 329-2763, Japan

    Zen’ichiro Wajima

  3. Department of Anesthesiology, Kaken Hospital, International University of Health and Welfare, 6-1-14 Kounodai, Ichikawa, Chiba, 272-0827, Japan

    Toshiya Shiga

  4. Division of Cardiovascular Anesthesia, Department of Anesthesia, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan

    Kazuyuki Imanaga

Authors
  1. Zen’ichiro Wajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiya Shiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuyuki Imanaga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zen’ichiro Wajima.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wajima, Z., Shiga, T. & Imanaga, K. Pneumoperitoneum affects stroke volume variation in humans. J Anesth 29, 508–514 (2015). https://doi.org/10.1007/s00540-014-1963-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-014-1963-y

Keywords

Search

Navigation