What are the respiratory effects of pneumoperitoneum (planned intraabdominal hypertension)?
- Pneumoperitoneum alters respiratory mechanics. Intraabdominal hypertension results in elevation of the diaphragm, decreases in functional residual capacity and total lung volume, ventilation-perfusion inequalities, and atelectasis.
- Some patients may require increased peak inspiratory pressure to compensate for decreased respiratory compliance.
- No significant change occurs in arterial oxygenation in healthy patients under pneumoperitoneum, but in patients with cardiopulmonary compromise, arterial oxygen desaturation has been reported, presumably secondary to mechanical pulmonary dysfunction.
Postoperative Pulmonary Function Tests: Open versus Laparoscopic Surgery
| Measurement at 24 Hours After Surgery | Percentage of Preoperative Value | |
|---|---|---|
| Open Surgery | Laparoscopic Surgery | |
| Forced vital capacity Forced expiratory volume at 1 second Forced expiratory flow at 25% to 75% | 54% 52% 53% | 73% 72% 81% |
