Transoesophageal echocardiographic assessment of haemodynamic function during laparoscopic cholecystectomy |
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Authors: | AJ Cunningham J Turner S Rosenbaum T Rafferty |
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Affiliation: | Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510. |
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Abstract: | We have measured cardiovascular changes associated with insufflation of carbon dioxide and the reverse Trendelenburg position during laparoscopic cholecystectomy, using transoesophageal echocardiography in 13 healthy patients. End-tidal carbon dioxide values increased after insufflation of carbon dioxide, with values significantly (P < 0.05) increased after lateral tilt positioning. Creation of a pneumoperitoneum was associated with increases (P < 0.05) in left ventricular end-systolic wall stress, concomitant with increases (P < 0.01) in peak airway pressure and systemic arterial pressure. In addition, left ventricular end-diastolic area decreased (P < 0.05) after reverse Trendelenburg positioning. Left ventricular ejection fraction was maintained throughout the study. |
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