Central and peripheral adverse hemodynamic changes during laparoscopic surgery and their reversal with a novel intermittent sequential pneumatic compression device.

摘要: Compared with open surgery, laparoscopic surgical procedures are associated reduced traumatic insult and metabolic stress to the patient hence a smoother postoperative period accelerated recovery. 1,2 On these grounds, approach has been proposed for surgery on high-risk patients comorbid cardiopulmonary disease. 3 However, there documented adverse cardiovascular, hormonal, neuroendocrine changes 1,4,5 caused by positive-pressure pneumoperitoneum (PPPn), have reports of sudden intraoperative cardiovascular collapse or severe pulmonary edema requiring ventilation after uneventful cholecystectomy. 6,7 The effects cardiac performance produced PPPn may increase risk complications in susceptible groups. 8–10 In addition central changes, results peripheral venous flow 11–16 diminished perfusion intraabdominal organs. 17–19 In addressing this problem, several remedies as contenders clinical evaluation. 20 One is mechanical solution that involves application intermittent sequential pneumatic compression (ISPC) lower limbs during surgery. beneficial ISPC devices induced documented. 15,16,21 present study was designed evaluate effect novel system (Lympha-press, Mego Afek Kibbutz afek 30042, Israel) both hemodynamic