INFLUENCE OF A PNEUMOPERITONEUM ON HEMODY NAMICS, SMALL-BOWEL MICROCIRCULATION AND POSTOPERATIVE INTEGRITY OF THE GUT - CARBON-DIOXIDE VERSUS HELIUM

A carbon dioxide pneumoperitoneum (CO2-PP) causes systemical effects o n acid-balance and hemodynamic stability. Elevated abdominal pressure and tissue acidosis influence intestinal circulation. In our study we focussed on a possible reduction of gut microcirculation during PP wit h CO2 and Helium (He) and possible long-term effects from reperfusion. We investigated on 14 healthy pigs. After a teady-state period a PP w as created with CO2 (n = 7) or He (n = 7) for 180 min., followed by a further investigation period of 120 min. Measured variables were hemod ynamics, tonometry, metabolic parameters and energy-metabolic status o f gut tissue probes. A CO2-PP causes more severe hemodynamic and acido tic effects. In tendency a He-PP is of less negative influence regardi ng intestinal integrity in respect to tonometric values and a signific ant higher level of ATP in gut tissue probes. None of the metabolic pa rameter showed significant effects regardless of the type of gas.