Hemodynamic Response to Laparoscopic Cholecystectomy – Impacts of Increased Afterload and Ischemic Dysfunction of the Left Ventricle

Title:

Hemodynamic Response to Laparoscopic Cholecystectomy – Impacts of Increased Afterload and Ischemic Dysfunction of the Left Ventricle

Creator:

Danzig, V., Krška, Z., Demeš, R., Danzigová, Z., Linhart, A., and Kittnar, O.

Identifier:

https://cdk.lib.cas.cz/client/handle/uuid:73173eaa-a746-4f81-ba4e-c1e567dbf807
uuid:73173eaa-a746-4f81-ba4e-c1e567dbf807

Subject:

Laparoscopic cholecystectomy, Hemodynamic response in cardiac patients, and Transesophageal echocardiography

Type:

article, model:article, and TEXT

Description:

The authors describe the results of intra-operative hemodynamic monitoring during laparoscopic cholecystectomy in patients with ischemic left ventricular dysfunction and with significant aortic stenosis. The results in the groups composed of 13 and 12 patients were compared with the findings in 10 young, non-obese, non-smokers without significant cardiovascular history and with normal findings during resting transthoracic echocardiography. Monitoring itself was conducted using transesophageal echocardiography 1) after the induction of anesthesia, 2) after the induction of capnoperitoneum, and 3) after setting the operative anti-Trendelenburg position. The measurements were performed at least in triplicate and the results were processed using ANOVA test. Significant differences were identified in the time course patterns of heart rate, mean arterial pressure, dual product (pressure-rate-product), and cardiac output. In terms of pathophysiology, we believe that the most important achievement was the identification of different time course patterns of individual parameters in the respective groups. The results in the group of patients with aortic stenosis were based particularly on the different time course of the mean arterial pressure, while the results in patients with ischemic disease were more dependent on the time course of the heart rate. Very ineteresting is a drop of peripheral vascular resistance after positioning of these patients which could be explained only partially by a beta-blocking or ACEI medication. In clinical terms, the most important finding was probably that no complications occurred in the entire group of 35 patients, of which 25 suffered from severe organic cardiopathies.

Language:

English

Rights:

http://creativecommons.org/licenses/by-nc-sa/4.0/
policy:public

Source:

Physiological research | 2005 Volume:54 | Number:4

Harvested from:

CDK

Metadata only:

false