The influence of increased intra-abdominal pressure on blood coagulation values. 1998

M Horzic, and A Korusic, and D Bunoza, and K Maric
Dubrava University Hospital, Zagreb, Croatia.

OBJECTIVE Increased intra-abdominal pressure during laparoscopic cholecystectomy changes pressure values in the thoracic cavity, in blood vessels, and in biochemical blood values. METHODS In this prospective study, we investigate whether CO2 pneumoperitoneum causes blood absorption and whether there is an increased risk of thromboembolism because of its mechanical influence on reographic and biochemical blood attributes. We analyzed pH, BE and arterial blood pCO2 pre-operatively, three times during surgery and post-operatively; and blood coagulation values pre-, during and 30 minutes after the operation. Blood samples were taken from 75 patients, divided into two groups. The first group consisted of 50 patients on whom laparoscopic cholecystectomies were performed, while the second (control) group consisted of 25 patients who were operated on by open laparotomy. All patients had a pre-operative physical status of ASA I and ASA II. RESULTS There was no statistically significant difference in pCO2 in any measurement, but in the group of patients treated with a laparoscopy there were statistically significant increases in pCO2 in three measurements during the operation. CONCLUSIONS The data show that during the laparoscopy the pneumoperitoneum had no physical or biochemical influence on coagulation values and so reduced the risk of thromboembolism.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010314 Partial Thromboplastin Time The time required for the appearance of FIBRIN strands following the mixing of PLASMA with phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides). It is a test of the intrinsic pathway (factors VIII, IX, XI, and XII) and the common pathway (fibrinogen, prothrombin, factors V and X) of BLOOD COAGULATION. It is used as a screening test and to monitor HEPARIN therapy. Activated Partial Thromboplastin Time,Cephalin-Kaolin Coagulation Time,Kaolin-Cephalin Coagulation Time,Thromboplastin Time, Partial,Coagulation Time, Cephalin-Kaolin,Cephalin Kaolin Coagulation Time,Coagulation Time, Cephalin Kaolin,Coagulation Time, Kaolin-Cephalin,Kaolin Cephalin Coagulation Time
D011028 Pneumoperitoneum, Artificial Deliberate introduction of air into the peritoneal cavity. Artificial Pneumoperitoneum
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011517 Prothrombin Time Clotting time of PLASMA recalcified in the presence of excess TISSUE THROMBOPLASTIN. Factors measured are FIBRINOGEN; PROTHROMBIN; FACTOR V; FACTOR VII; and FACTOR X. It is used for monitoring anticoagulant therapy with COUMARINS. Quick Test,Russell's Viper Venom Time,Thrombotest,Russell Viper Venom Time,Russells Viper Venom Time,Prothrombin Times,Test, Quick,Time, Prothrombin,Times, Prothrombin
D001777 Blood Coagulation The process of the interaction of BLOOD COAGULATION FACTORS that results in an insoluble FIBRIN clot. Blood Clotting,Coagulation, Blood,Blood Clottings,Clotting, Blood
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D005260 Female Females

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