Cardiovascular responses to prolonged carbon dioxide pneumoperitoneum in neonatal versus adolescent pigs

Background Long-lasting minimally invasive procedures are increasingly used for children. However, the hemodynamic effects of a prolonged carbon dioxide (CO 2 ) pneumoperitoneum (PP) on small infants are poorly understood and may differ from the effects on adolescents. This study aimed to detect and compare these effects in neonatal and adolescent pigs. Methods Six neonatal pigs weighing 5.6–6.4 kg and six adolescent pigs weighing 51–57 kg underwent a prolonged CO 2 PP of 180 min. Five neonatal pigs weighing 5.7–6.6 kg underwent sham PP as an additional control group. All the animals received crystalloid electrolyte solution at 10 ml/kg/h during the experiments. After CO 2 decompression, all the animals were monitored for a further 120 min. The end points of the study were mean arterial pressure (MAP), central venous pressure (CVP), and cardiac index (CI). The parameters were assessed after a 60-min resting phase (i.e., after initial placement of catheters in the jugular vein, the carotid artery, and the femoral artery four times during CO 2 PP and three times afterward. Results The comparison of neonates and adolescent pigs showed that neonates had a significantly more pronounced decrease in MAP during CO 2 PP (88.1 ± 2.7% of baseline vs 95.1 ± 1.6%; p