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Effect of increased intraabdominal pressure on cardiac output and tissue blood flow assessed by color-labeled microspheres in the pig

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Abstract

Background

Studies of the hemodynamic effects associated with the pneumoperitoneum have had controversial results. We set out to investigate the effect of increased intraabdominal pressure (IAP) on cardiac output and tissue blood flow in various intraabdominal and extraabdominal organs using the color-labeled microsphere (CLM) technique.

Methods

IAP was induced by CO2 insufflation in anesthetized pigs; 0,5, and 10 mmHg was used in the low-pressure group and 0, 15, and 24 mmHg in the high-pressure group. Tissue blood flow (ml.min−1.g−1) and cardiac output (CO) (ml/min) were determined by the CLM technique.

Results

CO decreased at IAP≥15 mmHg. Arterial PaCO2 and hydrogen ion concentration increased in response to all levels of IAP. Arterial PaO2, oxygen saturation, and bicarbonate ion concentration remained unchanged. Low IAP did not influence tissue blood flows in most of the organs. However, in the spleen, pancreas, esophagus, and gastric mucosal specimens, tissue blood flow was significantly decreased at 24 mmHg.

Conclusion

The level of IAP used in current practice (10–12 12 mmHg) appears to be safe with regard to hemodynamic variables and tissues blood flow; however, higher levels may induce a decrease in cardiac output and tissue blood flow.

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Authors and Affiliations

  1. National Center for Advanced Laparoscopic Surgery, Trondheim University Hospital, Olav Kyrres gt. 17, N-7006, Trondheim, Norway

    Y. Yavuz, K. Rønning & R. Mårvik

  2. Department of Surgery, Norwegian University of Science and Technology, Trondheim University Hospital, Olav Kyrres gt. 17, N-7006, Trondheim, Norway

    O. Lyng & J. E. Grønbech

Authors
  1. Y. Yavuz
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  2. K. Rønning
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  3. O. Lyng
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  4. R. Mårvik
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  5. J. E. Grønbech
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Online publication: 12 December 2000

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Yavuz, Y., Rønning, K., Lyng, O. et al. Effect of increased intraabdominal pressure on cardiac output and tissue blood flow assessed by color-labeled microspheres in the pig. Surg Endosc 15, 149–155 (2001). https://doi.org/10.1007/s004640000336

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  • DOI: https://doi.org/10.1007/s004640000336

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