Fdce. Silva et al., Laparoscopic pneumoperitoneum in acute peritonitis does not increase bacteremia or aggravate metabolic or hemodynamic disturbances, SURG LA E P, 10(5), 2000, pp. 305-310
The use of laparoscopy in generalized peritonitis has become increasingly f
requent in recent years. However, CO2 pneumoperitoneum in association with
increased intraperitoneal pressure may have deleterious effects in patients
with hemodynamic or metabolic disturbances caused by bacterial peritonitis
. The purpose of this study was to investigate the effect of CO2 pneumoperi
toneum on bacteremia, mean arterial pressure, and blood gas disturbances in
an animal model of bacterial peritonitis. Dogs were anesthetized, orally i
ntubated, and subjected to experimental peritonitis by intraperitoneal inoc
ulation of a suspension containing Escherichia coli and sterile dog feces.
The animals were randomly assigned to two groups: control animals were main
tained under anesthesia, and the insufflated animals were subjected to intr
aperitoneal CO2 insufflation. Bacterial peritonitis provoked the appearance
of bacteremia and a significant decrease in mean arterial pressure, pH, bi
carbonate, and base deficit. The induction of bacterial peritonitis did not
significantly influence pH in the control group and partial pressure of ar
terial CO2 in either group. Thirty minutes of CO2 pneumoperitoneum did not
influence the effect of bacterial peritonitis on the analyzed variables. Th
ese results suggest that laparoscopic CO2 pneumoperitoneum does not aggrava
te bacteremia or metabolic and hemodynamic disturbances induced by bacteria
l peritonitis.