Effects of pneumoperitoneum on splanchnic hemodynamics: an experimental study in pigs.

OBJECTIVE

To study the effects on splanchnic haemodynamics of pneumoperitoneum induced by carbon dioxide insufflation.

DESIGN

Controlled experimental study.

ANIMALS

11 Pigs weighing 19-30 kg.

INTERVENTION

The animals were divided into a control group (n = 4) and a experimental group (n = 7). Experimental animals were subjected to stepwise increasing intra-abdominal pressure from 0 mm Hg to 25 mm Hg by carbon dioxide insufflation.

MAIN OUTCOME MEASURES

Portal venous blood flow, portal venous blood pressure, portal/hepatic vascular resistance, and gastrointestinal vascular resistance.

RESULTS

At 25 mm Hg portal venous blood flow was reduced (66% of baseline), and portal venous blood pressure and portal/hepatic vascular resistance were increased (360% and 650% of baseline, respectively). The increase in gastrointestinal vascular resistance was less pronounced.

CONCLUSIONS

Increased intra-abdominal pressure caused significant changes in the splanchnic haemodynamics. The risk was greater if the intra-abdominal pressure exceeded 15 mm Hg.