Brain oxygenation during laparoscopic correction of hypertrophic pyloric stenosis

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Stefaan H A J TytgatD C van der Zee

Abstract

Concern remains about the safety of carbon dioxide (CO2) pneumoperitoneum (PP) in young infants having surgery for pyloric stenosis via laparoscopy. Interests here mainly focus on possible jeopardized organ perfusion and in particular brain oxygenation with possible adverse neurodevelopmental outcomes. The aim of this study was to investigate the intraoperative effects of CO2 gas PP on cerebral oxygenation during laparoscopic surgery for hypertrophic pyloric stenosis in young infants. In this single-center prospective observational study, we investigated brain oxygenation in 12 young infants receiving laparoscopic pyloromyotomy with CO2 PP, with a pressure of 8 mm Hg and a flow rate of 5 L/minute. Intraoperative hemodynamic parameters and transcranial near-infrared spectroscopy to assess regional cerebral oxygen saturation (rScO2) were monitored continuously during the whole procedure. Parameters were analyzed in four intervals: before insufflation (T0), during (start [T1] and end [T2]), and after cessation (T3) of the CO2 PP. Blood pressure and end-tidal CO2 (etCO2) increased during the procedure: mean arterial pressure, 35±5 mm Hg at T0 to 43±9 mm Hg at T2; etCO2, 35±4 mm Hg at T0 to 40±3 mm Hg at T3. The rScO2 remained stabl...Continue Reading

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Citations

Aug 16, 2016·Seminars in Pediatric Surgery·Matthew Jobson, Nigel J Hall
Jun 3, 2016·Journal of Minimal Access Surgery·Gloria PelizzoValeria Calcaterra
Dec 22, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Lucy HendersonHaitham Dagash
May 22, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Steffi MayerAnne Suttkus
Nov 6, 2018·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Mustafa O OztanGokhan Koyluoglu
May 16, 2020·European Journal of Anaesthesiology·Sophie A CosterusJurgen C de Graaff
Jul 22, 2019·Journal of Clinical Monitoring and Computing·Mineto KamataJoseph D Tobias
Mar 30, 2017·Frontiers in Pediatrics·Laura Marie Louise DixPetra Maria Anna Lemmers
Jul 20, 2020·The Journal of Surgical Research·Amanda MuñozJoanne Baerg

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