EFFECT OF CARBON-DIOXIDE PNEUMOPERITONEUM ON BACTEREMIA AND ENDOTOXEMIA IN AN ANIMAL-MODEL OF PERITONITIS

Laparoscopy is increasingly used in conditions complicated by peritoni tis. A theoretical concern is that carbon dioxide pneumoperitoneum may increase bacteraemia. This study examines the effect of carbon dioxid e pneumoperitoneum on bacteraemia, endotoxaemia and physiological corr elates of sepsis in an animal model of peritonitis. New Zealand white rabbits were assigned to three groups of six animals. Group 1 received an intraperitoneal inoculation of 10(9) colony-forming units of Esche richia coli followed by a 10-cm midline laparotomy. Group 2 received a n identical bacterial inoculum followed by a 12-mmHg carbon dioxide pn eumoperitoneum for 1 h. Group 3 received no bacteria but had a 12-mmHg carbon dioxide pneumoperitoneum for Ih. Groups 1 and 2 had significan tly higher levels of bacteraemia (P < 0.01) and endotoxaemia (P < 0.01 ) accompanied by significantly lower mean arterial pressures (P < 0.05 ) and higher heart rates (P < 0.05) compared with group 3. After 6 h g roups 1 and 2 were significantly hypocarbic (P < 0.01), leucopenic (P < 0.01) and thrombocytopenic (P < 0.01). There was no difference betwe en group 1 and group 2. A carbon dioxide pneumoperitoneum of 12 mmHg d oes not increase bacteraemia or endotoxaemia, nor does it adversely af fect physiological or laboratory correlates of sepsis compared with la parotomy in this animal model of peritonitis.