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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
Rubini A., Bosco G.
Department of Biomedical Sciences, Section Physiology, University of Padua, Padua, Italy
Aim: The aim of this paper was to investigate the consequences of pneumoperitoneum on respiratory system elastic and resistive mechanical properties and the related components of the inspiratory work of breathing.
Methods: We applied the end-inflation occlusion method in anesthetised, paralysed, positive-pressure ventilated rats (N.=8) to measure respiratory mechanics parameters. Modelling the respiratory system as composed of two distinct compartments, the method allows the measurements of elastance and of both the “ohmic” and the additional, viscoelastic component of inspiratory resistance which is due to viscoelastic effects, i.e. stress-relaxation. The measured data were used, together with inflation volume and flow values, to calculate the pneumoperitoneum effects on the total inspiratory work of breathing, which was also partitioned in its elastic, viscoelastic and ohmic components.
Results: Confirming previously reported results, we found that pneumoperitoneum induced a respiratory system mechanical derangement characterized by increments in both the elastic and resistive pressure dissipation, most of all in its viscoelastic component. Accordingly, significant increments in the various components of the work of breathing needed to inflate the respiratory system were demonstrated.
Conclusion: Pneumoperitoneum adversely affects respiratory mechanics because of the induced cephalad displacement of the diaphgram. The related increments of the various components of the inspiratory work of breathing are expected to occur during spontaneous breathing also, for example in clinical conditions characterised by abdominal hypertension, such as liver diseases, ascites or peritonitis.