SIMULTANEOUS HEMODYNAMIC AND ECHOCARDIOGRAPHIC CHANGES DURING ABDOMINAL GAS INSUFFLATION

The purpose of this study was to investigate cardiovascular changes du ring CO2 pneumoperitoneum. We performed simultaneous hemodynamic recor dings and transesophageal echocardiographic measurements of possible a lterations in cardiac dimensions. Seven patients scheduled for electiv e laparoscopic cholecystectomy were investigated. With an intraabdomin al pressure of 15 mm Hg, mean arterial pressure increased from 75 to 9 3 mm Hg (p<0.05). Despite the increase in pulmonary capillary wedge pr essure (PCWP) from 10 (9.5-12) to 17 (16-19.9) mm Hg (p<0.05), left ve ntricular end-diastolic area index (EDAI) did not change significantly . The cardiac index remained unchanged. Thus abdominal gas insufflatio n substantially alters the PCWP/EDAI relation. During pneumoperitoneum , left ventricular filling pressure, estimated by PCWP, cannot be used as an indicator of left ventricular dilatation.