Influence of extended pneumoperitoneum on piglets with cardiac failure

Abstract

Objective This experiment established a pneumoperitoneum model and acute cardiac failure model in piglets. It studies changes of hemodynamics of extended artificial pneumoperitoneum with CO2 and N2O in piglets with cardiac dysfunction. Methods Fourteen piglets (2-4 kilogram in weight,7-14 days of age) were divided into two groups: cardiac failure & CO2 group (CO2-HF) and cardiac failure & N2O group (N2O-HF). Both group underwent 4 hours of pneumoperitoneum. Measurements were carried out 5min before anaesthesia, 15,60,120, 180,240 min after establishing pneumoperitoneum and 30 min after deflation. Investigation included heart rete, stroke volume index, cardiac index, mean arterial pressure, central venous pressure, mean pulmonary arterial pressure, systemic vascular resistance index and dP/dtmax. Results In CO2-HF and N2O-HF groups,compared to the preoperative baseline, HR, SVI and CI decreased (P＜0. 05 ), while MPAP and SVRI increased (P＜0. 05). There was no statistical alteration in dP/dtmax, MAP and CVP. Post-operatively, HR were stable in both groups, CI decreased further, MPAP increased further and CVP increased(P＜0. 05). In CO2-HF group, MAP and dP/dtmax decreased,SVI decreased further and SVRI increased further(P＜0. 05). Conclusions Cardiac contractility decreased and systemic vascular resistance index increased significantly during extended CO2 pneumoperitoneum in piglets with compromised heart function. There was no deterioration of heart function with extended N2O pneumoperitoneum in piglets with heart failure. Key words: Pneumoperitoneum, artificial; Carbon dioxide; Nitrous oxide; Swine; Cardiovascular system