Pediatric Laparoscopy and Adaptive Oxygenation and Hemodynamic Changes

Gloria Pelizzo; Veronica Carlini; Giulio Iacob; Noemi Pasqua; Giuseppe Maggio; Marco Brunero; Simonetta Mencherini; Annalisa De Silvestri; Valeria Calcaterra

doi:10.4081/pr.2017.7214

Pediatric Laparoscopy and Adaptive Oxygenation and Hemodynamic Changes

Pediatr Rep. 2017 Jun 26;9(2):7214. doi: 10.4081/pr.2017.7214.

Authors

Gloria Pelizzo¹, Veronica Carlini², Giulio Iacob², Noemi Pasqua², Giuseppe Maggio³, Marco Brunero², Simonetta Mencherini³, Annalisa De Silvestri⁴, Valeria Calcaterra^{5

6}

Affiliations

¹ Pediatric Surgery Unit, Children's Hospital, Istituto Mediterraneo di Eccellenza Pediatrica, Palermo.
² Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia.
³ Anesthesiology and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia.
⁴ Biometry and Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia.
⁵ Pediatric Unit, Department of Maternal and Child Health Fondazione IRCCS Policlinico San Matteo Pavia, Italy.
⁶ Department of Internal Medicine an Therapeutics, University of Pavia, Italy.

Abstract

Adaptive changes in oxygenation and hemodynamics are evaluated during pediatric laparoscopy. The children underwent laparoscopy (LAP Group, n=20) or open surgery (Open Group, n=10). Regional cerebral (rScO₂) and peripheral oxygen saturation (SpO₂), heart rate (HR), diastolic (DP) and systolic pressure (SP) were monitored at different intervals: basal (T0); anesthesia induction (T1); CO₂PP insufflation (T2); surgery (T3); CO₂PP cessation (T4); before extubation (T5). At T1, in both the LAP and Open groups significant changes in rScO₂, DP and SP were recorded compared with T0; a decrease in SatO₂ was also observed at T5. In the LAP group, at T2, changes in HR related to CO₂PP pressure and in DP and SP related to IAP were noted; at T4, a SP change associated with CO₂PP desufflation was recorded. Open group, at T3 and T5 showed lower rScO₂ values compared with T1. Pneuperitoneum and anesthesia are influent to induce hemodynamics changes during laparoscopy.

Keywords: changes; children; hemodinamics; laparoscopy.