Laparoscopic pneumoperitoneum in acute peritonitis does not increase bacteremia or aggravate metabolic or hemodynamic disturbances

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.