CARDIORESPIRATORY EFFECTS OF LAPAROSCOPIC SURGERY

Lower cardiac output: The pneumoperitoneum required laparoscopic surge ry lowers cardiac output when the intraperitoneal pressure rises above 10-12 mmHg. At lower pressures, there is little effect on hemodynamic s. Cardiac output results from reduced venous return and increased per ipheral vascular resistance. Possible variations: Maintaining vascular volume and the Trendelenburg position improve hemodynamic conditions and favor venous return. The proclive position has the inverse effect Parietal suspension does not led to any hemodynamic or respiratory mod ifications. Respiratory consequences: Inflating the peritoneal cavity produces a state of hypercapnia. This results from CO2 absorption, cha nges in the thoraco-pulmonary mechanics and altered ventilation-perfus ion ratio. In practice: In patients with an uneventful past history, l aparoscopic surgery has little cardiorespiratory effect of the intrape ritoneal pressure is maintained below 12-15 mmHg.