Maternal and fetal effects of laparoscopic insufflation in the gravid baboon
Abstract Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus. Design. A descriptive physiologic study. Sett...
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| Veröffentlicht in: | The Journal of the American Association of Gynecologic Laparoscopists 1995-08, Vol.2 (4), p.399-406 |
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| creator | Reedy, Mark B. Galan, Henry L. Bean-Lijewski, Jolene D. Carnes, Alisa Knight, Alfred B. Kuehl, Thomas J. |
| description | Abstract
Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus.
Design. A descriptive physiologic study.
Setting. Animal research facility at Scott and White Memorial Hospital, Temple, TX.
Participants. Four pregnant baboons at 120±7 days' gestation.
Interventions. The baboons underwent general anesthesia, Swan-Ganz and arterial catheter placement, and abdominal insufflation at 10 and 20 mm Hg IAP for 20-minute intervals at each pressure. The following end points were measured: maternal heart rate (MHR), mean arterial pressure (MAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressures (PAP), central venous pressure (CVP), systemic vascular resistance (SVR), ventilator rate (VR), oxygen saturation, and end-tidal carbon dioxide (CO
2). Fetal heart rate and fetal growth values were measured, and umbilical artery Doppler flow studies were performed.
Measurements and Main Results. The PCWP (p |
| doi_str_mv | 10.1016/S1074-3804(05)80060-X |
| format | Article |
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Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus.
Design. A descriptive physiologic study.
Setting. Animal research facility at Scott and White Memorial Hospital, Temple, TX.
Participants. Four pregnant baboons at 120±7 days' gestation.
Interventions. The baboons underwent general anesthesia, Swan-Ganz and arterial catheter placement, and abdominal insufflation at 10 and 20 mm Hg IAP for 20-minute intervals at each pressure. The following end points were measured: maternal heart rate (MHR), mean arterial pressure (MAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressures (PAP), central venous pressure (CVP), systemic vascular resistance (SVR), ventilator rate (VR), oxygen saturation, and end-tidal carbon dioxide (CO
2). Fetal heart rate and fetal growth values were measured, and umbilical artery Doppler flow studies were performed.
Measurements and Main Results. The PCWP (p<0.026), CVP (p<0.0012), and PAP (p<0.046) were significantly increased at 20 mm Hg IAP; CO decreased as IP increased. The MAP, MHR, and SVR did not change significantly with increased IAP. The only significant change in pulmonary values was the increase in peak airway pressure (p<0.001). The VR was increased from an average of 18 to 41 breaths/minute in an attempt to maintain adequate oxygen saturation and to normalize end-tidal CO
2 when IAP was increased to 20 mm Hg. Respiratory acidosis (pH<7.35, partial pressure of carbon dioxide >50 torr) was demonstrated in three of four animals within 20 minute at an IAP of 20 mm Hg. Results of Doppler flow studies on the effects of the fetuses were unaltered immediately after this procedure compared with baseline measurements. Normal interval growth was demonstrated 2 weeks after the procedure.
Conclusion. The baboon mothers and fetuses had no adverse effects at an IAP of 10 mm Hg, but may have significant cardiovascular and respiratory alterations associated with IAP of 20 mm Hg.</description><identifier>ISSN: 1074-3804</identifier><identifier>EISSN: 2213-8870</identifier><identifier>DOI: 10.1016/S1074-3804(05)80060-X</identifier><identifier>PMID: 9050592</identifier><language>eng</language><publisher>United States</publisher><subject>Acidosis, Respiratory - etiology ; Anesthesia, General ; Animals ; Blood Pressure - physiology ; Carbon Dioxide - metabolism ; Cardiac Output - physiology ; Catheterization, Peripheral ; Catheterization, Swan-Ganz ; Central Venous Pressure - physiology ; Embryonic and Fetal Development ; Female ; Fetus - physiology ; Gestational Age ; Heart Rate - physiology ; Heart Rate, Fetal - physiology ; Hemodynamics - physiology ; Insufflation - methods ; Laparoscopy - methods ; Lung - embryology ; Lung - physiology ; Oxygen - blood ; Papio ; Pregnancy ; Pregnancy, Animal - physiology ; Pressure ; Pulmonary Artery ; Pulmonary Wedge Pressure - physiology ; Respiration - physiology ; Tidal Volume ; Ultrasonography, Doppler ; Umbilical Arteries - diagnostic imaging ; Umbilical Arteries - physiology ; Vascular Resistance - physiology</subject><ispartof>The Journal of the American Association of Gynecologic Laparoscopists, 1995-08, Vol.2 (4), p.399-406</ispartof><rights>1995 The Journal of the American Association of Gynecologic Laparoscopists</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-ea21cb19d16dbfcc97a4887e469f5123c1deaa9ed9555e6d2a42020873d5749b3</citedby><cites>FETCH-LOGICAL-c426t-ea21cb19d16dbfcc97a4887e469f5123c1deaa9ed9555e6d2a42020873d5749b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9050592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reedy, Mark B.</creatorcontrib><creatorcontrib>Galan, Henry L.</creatorcontrib><creatorcontrib>Bean-Lijewski, Jolene D.</creatorcontrib><creatorcontrib>Carnes, Alisa</creatorcontrib><creatorcontrib>Knight, Alfred B.</creatorcontrib><creatorcontrib>Kuehl, Thomas J.</creatorcontrib><title>Maternal and fetal effects of laparoscopic insufflation in the gravid baboon</title><title>The Journal of the American Association of Gynecologic Laparoscopists</title><addtitle>J Am Assoc Gynecol Laparosc</addtitle><description>Abstract
Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus.
Design. A descriptive physiologic study.
Setting. Animal research facility at Scott and White Memorial Hospital, Temple, TX.
Participants. Four pregnant baboons at 120±7 days' gestation.
Interventions. The baboons underwent general anesthesia, Swan-Ganz and arterial catheter placement, and abdominal insufflation at 10 and 20 mm Hg IAP for 20-minute intervals at each pressure. The following end points were measured: maternal heart rate (MHR), mean arterial pressure (MAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressures (PAP), central venous pressure (CVP), systemic vascular resistance (SVR), ventilator rate (VR), oxygen saturation, and end-tidal carbon dioxide (CO
2). Fetal heart rate and fetal growth values were measured, and umbilical artery Doppler flow studies were performed.
Measurements and Main Results. The PCWP (p<0.026), CVP (p<0.0012), and PAP (p<0.046) were significantly increased at 20 mm Hg IAP; CO decreased as IP increased. The MAP, MHR, and SVR did not change significantly with increased IAP. The only significant change in pulmonary values was the increase in peak airway pressure (p<0.001). The VR was increased from an average of 18 to 41 breaths/minute in an attempt to maintain adequate oxygen saturation and to normalize end-tidal CO
2 when IAP was increased to 20 mm Hg. Respiratory acidosis (pH<7.35, partial pressure of carbon dioxide >50 torr) was demonstrated in three of four animals within 20 minute at an IAP of 20 mm Hg. Results of Doppler flow studies on the effects of the fetuses were unaltered immediately after this procedure compared with baseline measurements. Normal interval growth was demonstrated 2 weeks after the procedure.
Conclusion. The baboon mothers and fetuses had no adverse effects at an IAP of 10 mm Hg, but may have significant cardiovascular and respiratory alterations associated with IAP of 20 mm Hg.</description><subject>Acidosis, Respiratory - etiology</subject><subject>Anesthesia, General</subject><subject>Animals</subject><subject>Blood Pressure - physiology</subject><subject>Carbon Dioxide - metabolism</subject><subject>Cardiac Output - physiology</subject><subject>Catheterization, Peripheral</subject><subject>Catheterization, Swan-Ganz</subject><subject>Central Venous Pressure - physiology</subject><subject>Embryonic and Fetal Development</subject><subject>Female</subject><subject>Fetus - physiology</subject><subject>Gestational Age</subject><subject>Heart Rate - physiology</subject><subject>Heart Rate, Fetal - physiology</subject><subject>Hemodynamics - physiology</subject><subject>Insufflation - methods</subject><subject>Laparoscopy - methods</subject><subject>Lung - embryology</subject><subject>Lung - physiology</subject><subject>Oxygen - blood</subject><subject>Papio</subject><subject>Pregnancy</subject><subject>Pregnancy, Animal - physiology</subject><subject>Pressure</subject><subject>Pulmonary Artery</subject><subject>Pulmonary Wedge Pressure - physiology</subject><subject>Respiration - physiology</subject><subject>Tidal Volume</subject><subject>Ultrasonography, Doppler</subject><subject>Umbilical Arteries - diagnostic imaging</subject><subject>Umbilical Arteries - physiology</subject><subject>Vascular Resistance - physiology</subject><issn>1074-3804</issn><issn>2213-8870</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1PHDEMhqOKCra0PwFpTogepnUyk2RyqtCKFqSteihIe4syiVOCZifbZAaJf0_2Q1w52ZZf-7UfQi4ofKNAxfe_FGRbNx20V8C_dgAC6vUHsmCMNnXXSTghizfJGfmU8xMAk0LJU3KqgANXbEFWv82EaTRDZUZXeZxKht6jnXIVfTWYrUkx27gNtgpjnr0fzBTiWIpqesTqXzLPwVW96WMcP5OP3gwZvxzjOXn4eXO_vK1Xf37dLa9XtW2ZmGo0jNqeKkeF6721Spq2HIytUJ5T1ljq0BiFTnHOUThmWgYMOtk4LlvVN-fk8rB3m-L_GfOkNyFbHAYzYpyzllK1XEhRhPwgtOWJnNDrbQobk140Bb2jqPcU9Q6RBq73FPW6zF0cDeZ-g-5t6oit9H8c-li-fA6YdLYBR4supIJOuxjecXgF3X2CHQ</recordid><startdate>19950801</startdate><enddate>19950801</enddate><creator>Reedy, Mark B.</creator><creator>Galan, Henry L.</creator><creator>Bean-Lijewski, Jolene D.</creator><creator>Carnes, Alisa</creator><creator>Knight, Alfred B.</creator><creator>Kuehl, Thomas J.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950801</creationdate><title>Maternal and fetal effects of laparoscopic insufflation in the gravid baboon</title><author>Reedy, Mark B. ; Galan, Henry L. ; Bean-Lijewski, Jolene D. ; Carnes, Alisa ; Knight, Alfred B. ; Kuehl, Thomas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-ea21cb19d16dbfcc97a4887e469f5123c1deaa9ed9555e6d2a42020873d5749b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Acidosis, Respiratory - etiology</topic><topic>Anesthesia, General</topic><topic>Animals</topic><topic>Blood Pressure - physiology</topic><topic>Carbon Dioxide - metabolism</topic><topic>Cardiac Output - physiology</topic><topic>Catheterization, Peripheral</topic><topic>Catheterization, Swan-Ganz</topic><topic>Central Venous Pressure - physiology</topic><topic>Embryonic and Fetal Development</topic><topic>Female</topic><topic>Fetus - physiology</topic><topic>Gestational Age</topic><topic>Heart Rate - physiology</topic><topic>Heart Rate, Fetal - physiology</topic><topic>Hemodynamics - physiology</topic><topic>Insufflation - methods</topic><topic>Laparoscopy - methods</topic><topic>Lung - embryology</topic><topic>Lung - physiology</topic><topic>Oxygen - blood</topic><topic>Papio</topic><topic>Pregnancy</topic><topic>Pregnancy, Animal - physiology</topic><topic>Pressure</topic><topic>Pulmonary Artery</topic><topic>Pulmonary Wedge Pressure - physiology</topic><topic>Respiration - physiology</topic><topic>Tidal Volume</topic><topic>Ultrasonography, Doppler</topic><topic>Umbilical Arteries - diagnostic imaging</topic><topic>Umbilical Arteries - physiology</topic><topic>Vascular Resistance - physiology</topic><toplevel>online_resources</toplevel><creatorcontrib>Reedy, Mark B.</creatorcontrib><creatorcontrib>Galan, Henry L.</creatorcontrib><creatorcontrib>Bean-Lijewski, Jolene D.</creatorcontrib><creatorcontrib>Carnes, Alisa</creatorcontrib><creatorcontrib>Knight, Alfred B.</creatorcontrib><creatorcontrib>Kuehl, Thomas J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of the American Association of Gynecologic Laparoscopists</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reedy, Mark B.</au><au>Galan, Henry L.</au><au>Bean-Lijewski, Jolene D.</au><au>Carnes, Alisa</au><au>Knight, Alfred B.</au><au>Kuehl, Thomas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal and fetal effects of laparoscopic insufflation in the gravid baboon</atitle><jtitle>The Journal of the American Association of Gynecologic Laparoscopists</jtitle><addtitle>J Am Assoc Gynecol Laparosc</addtitle><date>1995-08-01</date><risdate>1995</risdate><volume>2</volume><issue>4</issue><spage>399</spage><epage>406</epage><pages>399-406</pages><issn>1074-3804</issn><eissn>2213-8870</eissn><abstract>Abstract
Study Objective. To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus.
Design. A descriptive physiologic study.
Setting. Animal research facility at Scott and White Memorial Hospital, Temple, TX.
Participants. Four pregnant baboons at 120±7 days' gestation.
Interventions. The baboons underwent general anesthesia, Swan-Ganz and arterial catheter placement, and abdominal insufflation at 10 and 20 mm Hg IAP for 20-minute intervals at each pressure. The following end points were measured: maternal heart rate (MHR), mean arterial pressure (MAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressures (PAP), central venous pressure (CVP), systemic vascular resistance (SVR), ventilator rate (VR), oxygen saturation, and end-tidal carbon dioxide (CO
2). Fetal heart rate and fetal growth values were measured, and umbilical artery Doppler flow studies were performed.
Measurements and Main Results. The PCWP (p<0.026), CVP (p<0.0012), and PAP (p<0.046) were significantly increased at 20 mm Hg IAP; CO decreased as IP increased. The MAP, MHR, and SVR did not change significantly with increased IAP. The only significant change in pulmonary values was the increase in peak airway pressure (p<0.001). The VR was increased from an average of 18 to 41 breaths/minute in an attempt to maintain adequate oxygen saturation and to normalize end-tidal CO
2 when IAP was increased to 20 mm Hg. Respiratory acidosis (pH<7.35, partial pressure of carbon dioxide >50 torr) was demonstrated in three of four animals within 20 minute at an IAP of 20 mm Hg. Results of Doppler flow studies on the effects of the fetuses were unaltered immediately after this procedure compared with baseline measurements. Normal interval growth was demonstrated 2 weeks after the procedure.
Conclusion. The baboon mothers and fetuses had no adverse effects at an IAP of 10 mm Hg, but may have significant cardiovascular and respiratory alterations associated with IAP of 20 mm Hg.</abstract><cop>United States</cop><pmid>9050592</pmid><doi>10.1016/S1074-3804(05)80060-X</doi><tpages>8</tpages></addata></record> |
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| ispartof | The Journal of the American Association of Gynecologic Laparoscopists, 1995-08, Vol.2 (4), p.399-406 |
| issn | 1074-3804 2213-8870 |
| language | eng |
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| subjects | Acidosis, Respiratory - etiology Anesthesia, General Animals Blood Pressure - physiology Carbon Dioxide - metabolism Cardiac Output - physiology Catheterization, Peripheral Catheterization, Swan-Ganz Central Venous Pressure - physiology Embryonic and Fetal Development Female Fetus - physiology Gestational Age Heart Rate - physiology Heart Rate, Fetal - physiology Hemodynamics - physiology Insufflation - methods Laparoscopy - methods Lung - embryology Lung - physiology Oxygen - blood Papio Pregnancy Pregnancy, Animal - physiology Pressure Pulmonary Artery Pulmonary Wedge Pressure - physiology Respiration - physiology Tidal Volume Ultrasonography, Doppler Umbilical Arteries - diagnostic imaging Umbilical Arteries - physiology Vascular Resistance - physiology |
| title | Maternal and fetal effects of laparoscopic insufflation in the gravid baboon |
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