Cardiorespiratory changes in children during laparoscopy

Abstract

The authors prospectively examined the cardiorespiratory changes during brief laparoscopy (less than 15 minutes) in children. Intraoperative ventilatory management included a tidal volume of 12 mL/kg, with the rate adjusted to achieve an end-tidal CO 2 (PETCO 2) of 30 to 35 mm Hg. The initial rate and tidal volume were not changed during the procedure. Baseline measurements of heart rate, blood pressure, peak inflating pressure (PIP), PETCO[in2], and oxygen saturation were recorded every minute for 5 minutes before the start of the laparoscopic procedure, and every minute during the laparoscopic procedure. Fifty-five patients were enrolled in the study (age range, 1 month to 7 years; weight range, 5.2 to 31 kg). PIP increased from the baseline value of 20 ± 2.5 to 23 ± 3.2 cm H 2O ( P < .01) during laparoscopy. The increase in PIP was 5 or more in six patients, with a maximum of 7. PETCO 2 increased from the baseline value of 32 ± 3.1 to 35 ± 4.8 mm Hg ( P < .01). The PETCO 2 returned to baseline within 10 minutes after completion of the laparoscopy. No increase in ventilatory parameters was required during the brief laparoscopic procedure.