Korean J Anesthesiol.  1999 Jul;37(1):13-18. 10.4097/kjae.1999.37.1.13.

The Effects of Increased Abdominal Pressure on Respiratory System Compliance during Laparoscopic Cholecystectomy

• Cho SY
• Han JU
• Yeom JH
• Shin WJ
• Kim YC
• Lee DH
• Park HK

• KMID: 2236836
• DOI: http://doi.org/10.4097/kjae.1999.37.1.13

Abstract

BACKGROUND: We examined whether increases of intra-abdominal pressure would decrease compliance (C) of both lung and chest wall.
METHODS
We measured airway and esophageal pressure in 10 anesthetized/paralyzed tracheally intubated patients during mechanical ventilation at the respiratory rate of 10 freq/min and the tidal volume of 10 ml/kg undergoing laparoscopic cholecystectomy. Measurements were made at 0 mmHg intra- abdominal pressure the (Pab) in supine position and at 15 mmHg Pab in 10 head-up (reverse Trendelenburg) position at 0, 5, 10 and 15 min. after CO2 insufflation.
RESULTS
We found that abdominal carbon dioxide insufflation caused a marked increase in peak airway pressure, plateau pressure and esophageal pressure (p<0.05); a reduction in compliance of respiratory system and chest wall (p<0.05).
CONCLUSION
These changes should be considered in patients such as those with pulmonary disease, undergoing laparoscopic cholecystectomy where increase in impendance may be critical.

MeSH Terms

Carbon Dioxide
Cholecystectomy, Laparoscopic*
Compliance*
Humans
Insufflation
Lung
Lung Diseases
Respiration, Artificial
Respiratory Rate
Respiratory System*
Supine Position
Thoracic Wall
Tidal Volume
Carbon Dioxide