TY - JOUR
T1 - Cardiovascular and Ventilatory Consequences of Laparoscopic Surgery
AU - Atkinson, Tamara M.
AU - Giraud, George D.
AU - Togioka, Brandon M.
AU - Jones, Daniel B.
AU - Cigarroa, Joaquin E.
N1 - Publisher Copyright:
© 2017 American Heart Association, Inc.
PY - 2017/2/14
Y1 - 2017/2/14
N2 - Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance. Hemodynamic effects are accentuated in patients with cardiovascular disease such as congestive heart failure, ischemic heart disease, valvular heart disease, pulmonary hypertension, and congenital heart disease. Prevention of cardiovascular complications may be accomplished through a sound understanding of the hemodynamic and physiological consequences of laparoscopic surgery as well as a defined operative plan generated by a multidisciplinary team involving the preoperative consultant, anesthesiologist, and surgeon.
AB - Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance. Hemodynamic effects are accentuated in patients with cardiovascular disease such as congestive heart failure, ischemic heart disease, valvular heart disease, pulmonary hypertension, and congenital heart disease. Prevention of cardiovascular complications may be accomplished through a sound understanding of the hemodynamic and physiological consequences of laparoscopic surgery as well as a defined operative plan generated by a multidisciplinary team involving the preoperative consultant, anesthesiologist, and surgeon.
KW - cardiovascular complications
KW - surgery
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UR - http://www.scopus.com/inward/citedby.url?scp=85012882299&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.116.023262
DO - 10.1161/CIRCULATIONAHA.116.023262
M3 - Article
C2 - 28193800
AN - SCOPUS:85012882299
SN - 0009-7322
VL - 135
SP - 700
EP - 710
JO - Circulation
JF - Circulation
IS - 7
ER -