Artificial ventilation during pneumoperitoneum

Comuzzi, Lucia and Roncally-Carvalho, Alysson and Lucangelo, Umberto and Araujo Zin, Walter (2014) Artificial ventilation during pneumoperitoneum. Shortness of Breath, 3 (2). pp. 58-67. ISSN 2281-6550

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Laparoscopic surgery has been increasingly used in many surgical subspecialties, due to its various post-operative benefits. On the other hand, it presents intra-operative challenges to the anesthesia management. The inflation of the abdominal cavity with carbon dioxide leads to hemodynamic changes, mechanical respiratory system derangements (increased elastance, resistance and airway pressure), augmented V’CO2, and alterations of the V’/Q’ ratio and of the PaCO2-PetCO2 gradient. All these changes may be influenced by other factors, such as body position and baseline characteristics of the patient. To minimize the negative consequences of these modifications a protective ventilation strategy with the use of low tidal volumes and PEEP, eventually associated with recruitment maneuvers, is suggested. No ventilatory mode or anesthetic drug has been proven better than the others. It has been suggested that the use of supraglotic devices may be a safe alternative to endotracheal intubation during laparoscopic surgery. It is important that the anesthetist be aware of 58 Shortness of Breath 2014; 3 (2): 58-67 the complications pertaining to pneumoperitoneum to solve them quickly, paying particular attention to the patients at higher risk, such as elderly, obese, and those with cardiopulmonary disease.

Item Type: Article
Uncontrolled Keywords: pneumoperitoneum, artificial ventilation, obesity, laparoscopy, anesthesia
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici)
Depositing User: Marina Spanti
Date Deposited: 21 Jan 2016 17:53
Last Modified: 21 Jan 2016 17:53

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