Does pneumoperitoneum with different gases, body positions, and intraperitoneal pressures influence renal and hepatic blood flow?
GROUND: Because of the well-known negative effects of carbon dioxide pneumoperitoneum on the hemodynamic and respiratory system, it was questionable how pneumoperitoneum may affect hepatic and renal blood flow. Therefore the influences of different gases, different intraperitoneal pressures, and different body positions on hepatic and renal blood flow were investigated in a porcine model. METHODS: Cardiac and hemodynamic function were monitored by means of implanted catheters in the pulmonary artery and the femoral vein and artery. Renal and hepatic blood flow were recorded with a transonic volume flow meter placed at the renal and hepatic arteries and the portal vein. Eighteen animals were randomly assigned to receive one of three insufflation gases (carbon dioxide [CO2], argon, or helium. After baseline recording, one of three intraperitoneal pressures (8, 12, or 16 mm Hg) and one of three body positions (supine head up, or head down) were randomly chosen. After an adaptation time of