The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Gerald M. Fried - One of the best experts on this subject based on the ideXlab platform.
-
Effect of Pneumoperitoneum on renal perfusion and function: A systematic review
Surgical Endoscopy, 2007Co-Authors: Scbastian Demyttenaere, Liane S. Feldman, Gerald M. FriedAbstract:Background The precise physiologic consequences of insufflating carbon dioxide into the abdominal cavity during laparoscopy are not yet fully understood. This systematic review aimed to investigate whether Pneumoperitoneum results in decreased renal blood flow (RBF) or renal function. Methods A literature search was conducted electronically using Medline, Embase, and the Cochrane libraries on 1 July 2005. Various combinations of the medical subject headings—renal blood flow, Pneumoperitoneum, renal function, and laparoscopy—were searched in all three databases. Reference lists from articles fulfilling the search criteria were used to identify additional articles. Results The literature search retrieved 20 articles concerning RBF and 25 articles concerning renal function during Pneumoperitoneum. It was found that 17 of the 20 studies identified a decrease in RBF, and 20 of the 25 studies identified a decrease in renal function during Pneumoperitoneum. Conclusion There appears to be sufficient evidence to conclude that both renal function and RBF are decreased during Pneumoperitoneum. The magnitude of the decrease is dependent on factors such as preoperative renal function, level of hydration, level of Pneumoperitoneum, patient positioning, and duration of Pneumoperitoneum.
-
effect of Pneumoperitoneum on renal perfusion and function a systematic review
Surgical Endoscopy and Other Interventional Techniques, 2007Co-Authors: Scbastian Demyttenaere, Liane S. Feldman, Gerald M. FriedAbstract:The precise physiologic consequences of insufflating carbon dioxide into the abdominal cavity during laparoscopy are not yet fully understood. This systematic review aimed to investigate whether Pneumoperitoneum results in decreased renal blood flow (RBF) or renal function. A literature search was conducted electronically using Medline, Embase, and the Cochrane libraries on 1 July 2005. Various combinations of the medical subject headings—renal blood flow, Pneumoperitoneum, renal function, and laparoscopy—were searched in all three databases. Reference lists from articles fulfilling the search criteria were used to identify additional articles. The literature search retrieved 20 articles concerning RBF and 25 articles concerning renal function during Pneumoperitoneum. It was found that 17 of the 20 studies identified a decrease in RBF, and 20 of the 25 studies identified a decrease in renal function during Pneumoperitoneum. There appears to be sufficient evidence to conclude that both renal function and RBF are decreased during Pneumoperitoneum. The magnitude of the decrease is dependent on factors such as preoperative renal function, level of hydration, level of Pneumoperitoneum, patient positioning, and duration of Pneumoperitoneum.
Linas Dziukas - One of the best experts on this subject based on the ideXlab platform.
-
Tension Pneumoperitoneum after cardiopulmonary resuscitation.
The Medical journal of Australia, 1991Co-Authors: Peter Cameron, Pamela L Rosengarten, William R. Johnson, Linas DziukasAbstract:OBJECTIVE To increase awareness of the unusual complication of Pneumoperitoneum after cardiopulmonary resuscitation. CLINICAL FEATURES A 57-year-old male farmer with a history of chronic renal failure and heart disease, as well as severe oesophageal reflux for which fundoplication had been performed, developed a tension Pneumoperitoneum after cardiopulmonary resuscitation. This resulted in lower limb cyanosis and an erection, a previously unreported complication. INTERVENTION AND OUTCOME The tension was relieved by uncapping a peritoneal dialysis catheter that was in situ. The cyanosis and erection resolved immediately, suggesting that the tension Pneumoperitoneum had caused significant venous obstruction. A 3 cm defect in the posterior wall of the stomach was repaired. CONCLUSION The likelihood of Pneumoperitoneum is reduced if standard guidelines for cardiopulmonary resuscitation are adhered to.
Sung Hwan Jung - One of the best experts on this subject based on the ideXlab platform.
-
the effect of Pneumoperitoneum and trendelenburg position on respiratory mechanics during pelviscopic surgery
Korean Journal of Anesthesiology, 2010Co-Authors: Kyu Wan Seong, Sung Hwan JungAbstract:Background: Conventional pelviscopic surgery requires Pneumoperitoneum with CO2 gas insufflation and lithotomy-Trendelenburg position. Pneumoperitoneum and Trendelenburg position may influence intraoperative respiratory mechanics in anesthetic management. This study was conducted to investigate the influence of Pneumoperitoneum and Trendelenburg position on respiratory compliance and ventilation pressure. Methods: Twenty-five patients scheduled for elective gynecologic laparoscopy were evaluated. The patients had no preexisting lung or heart disease or pathologic lung function. Conventional general anesthesia with thiopental sodium, lidocaine, rocuronium, and sevoflurane was administered. The peak inspiratory pressure, plateau pressure, and end-tidal CO2 were measured before and after creation of Pneumoperitoneum with an intraabdominal pressure of 12 mmHg, then after 10 minutes and 30 minutes in the 20 o Trendelenburg position, and after deflation of Pneumoperitoneum. The dynamic lung compliance was then calculated. Results: Following creation of Pneumoperitoneum, there was a significant increase in peak inspiratory pressure (6 cmH2O), plateau pressure (7 cmH2O), and end-tidal CO2 (5 mmHg), while dynamic lung compliance decreased by 12 ml/cmH2O. Overall, the Trendelenburg position induced no significant hemodynamic or pulmonary changes. Conclusions: The effects of Pneumoperitoneum significantly reduced dynamic lung compliance and increased peak inspiratory and plateau pressures. The Tredelenburg position did not change these parameters. (Korean J Anesthesiol 2010; 59: 329-334)
Thomas J. Maatman - One of the best experts on this subject based on the ideXlab platform.
-
The impact of low pressure Pneumoperitoneum in robotic assisted radical prostatectomy: a prospective, randomized, double blinded trial
World Journal of Urology, 2020Co-Authors: Matthew Rohloff, Greggory Peifer, Jaschar Shakuri-rad, Thomas J. MaatmanAbstract:Background Robotic surgery has revolutionized postoperative outcomes across surgical specialties. However, the use of Pneumoperitoneum comes with known risks given the change in physiological parameters that accompany its utilization. A recent internal review found a 7% decrease in postoperative ileus rates when utilizing a Pneumoperitoneum of 12 mmHg over the standard 15 mmHg in robotic assisted radical prostatectomies (RARP). Objective The purpose of this study is to prospectively evaluate the utility of lower pressure Pneumoperitoneum by comparing 8 mmHg and 12 mmHg during RARP. Design, setting and partcipants Patients were randomly assigned to undergo robotic assisted radical prostatectomy at a Pneumoperitoneum pressure of 12 mmHg or 8 mmHg. Outcome measurements and statistical analysis The primary outcome was development of postoperative ileus and secondary outcomes were length of operation, estimated blood loss and positive surgical margin status. Results and limitations A total of 201 patients were analyzed; 96 patients at 8 mmHg and 105 patients at 12 mmHg. The groups were adequately matched as there were no differences between demographic parameters or medical comorbidities. There was a decrease in postoperative ileus rates with lower Pneumoperitoneum pressures; 2% at 8 mmHg and 4.8% at 12 mmHg. There were no clinically significant differences in estimated blood loss, total length of operative time and positive margin status. Conclusions Lower pressure Pneumoperitoneum during robotic assisted radical prostatectomy is non-inferior to higher pressure Pneumoperitoneum levels and the experienced surgeon may safely perform this operation at 8 mmHg to take advantage of the proposed benefits.
Scbastian Demyttenaere - One of the best experts on this subject based on the ideXlab platform.
-
Effect of Pneumoperitoneum on renal perfusion and function: A systematic review
Surgical Endoscopy, 2007Co-Authors: Scbastian Demyttenaere, Liane S. Feldman, Gerald M. FriedAbstract:Background The precise physiologic consequences of insufflating carbon dioxide into the abdominal cavity during laparoscopy are not yet fully understood. This systematic review aimed to investigate whether Pneumoperitoneum results in decreased renal blood flow (RBF) or renal function. Methods A literature search was conducted electronically using Medline, Embase, and the Cochrane libraries on 1 July 2005. Various combinations of the medical subject headings—renal blood flow, Pneumoperitoneum, renal function, and laparoscopy—were searched in all three databases. Reference lists from articles fulfilling the search criteria were used to identify additional articles. Results The literature search retrieved 20 articles concerning RBF and 25 articles concerning renal function during Pneumoperitoneum. It was found that 17 of the 20 studies identified a decrease in RBF, and 20 of the 25 studies identified a decrease in renal function during Pneumoperitoneum. Conclusion There appears to be sufficient evidence to conclude that both renal function and RBF are decreased during Pneumoperitoneum. The magnitude of the decrease is dependent on factors such as preoperative renal function, level of hydration, level of Pneumoperitoneum, patient positioning, and duration of Pneumoperitoneum.
-
effect of Pneumoperitoneum on renal perfusion and function a systematic review
Surgical Endoscopy and Other Interventional Techniques, 2007Co-Authors: Scbastian Demyttenaere, Liane S. Feldman, Gerald M. FriedAbstract:The precise physiologic consequences of insufflating carbon dioxide into the abdominal cavity during laparoscopy are not yet fully understood. This systematic review aimed to investigate whether Pneumoperitoneum results in decreased renal blood flow (RBF) or renal function. A literature search was conducted electronically using Medline, Embase, and the Cochrane libraries on 1 July 2005. Various combinations of the medical subject headings—renal blood flow, Pneumoperitoneum, renal function, and laparoscopy—were searched in all three databases. Reference lists from articles fulfilling the search criteria were used to identify additional articles. The literature search retrieved 20 articles concerning RBF and 25 articles concerning renal function during Pneumoperitoneum. It was found that 17 of the 20 studies identified a decrease in RBF, and 20 of the 25 studies identified a decrease in renal function during Pneumoperitoneum. There appears to be sufficient evidence to conclude that both renal function and RBF are decreased during Pneumoperitoneum. The magnitude of the decrease is dependent on factors such as preoperative renal function, level of hydration, level of Pneumoperitoneum, patient positioning, and duration of Pneumoperitoneum.
