Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Colégio Brasileiro de Cirurgiões |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000200158 |
Resumo: | ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery. |
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Revista do Colégio Brasileiro de Cirurgiões |
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Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomyBlood PressureHemodynamicsEchocardiography, TransesophagealAgedLaparoscopyPneumoperitoneum, Artificial.ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery.Colégio Brasileiro de Cirurgiões2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000200158Revista do Colégio Brasileiro de Cirurgiões v.45 n.2 2018reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-6991e-20181659info:eu-repo/semantics/openAccessRAMOS,LUIZ PAULO JACOMELLIARAÚJO,RODRIGO BARCELLOSCASTRO,MARIA DO CARMO VALENTERAMOS,MARIA ROBERTA MENEGUETTI SERAVALLICUNHA-E-SILVA,JOSÉ ANTONIOIGLESIAS,ANTONIO CARLOSeng2018-05-22T00:00:00Zoai:scielo:S0100-69912018000200158Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2018-05-22T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false |
dc.title.none.fl_str_mv |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
title |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
spellingShingle |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy RAMOS,LUIZ PAULO JACOMELLI Blood Pressure Hemodynamics Echocardiography, Transesophageal Aged Laparoscopy Pneumoperitoneum, Artificial. |
title_short |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
title_full |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
title_fullStr |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
title_full_unstemmed |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
title_sort |
Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy |
author |
RAMOS,LUIZ PAULO JACOMELLI |
author_facet |
RAMOS,LUIZ PAULO JACOMELLI ARAÚJO,RODRIGO BARCELLOS CASTRO,MARIA DO CARMO VALENTE RAMOS,MARIA ROBERTA MENEGUETTI SERAVALLI CUNHA-E-SILVA,JOSÉ ANTONIO IGLESIAS,ANTONIO CARLOS |
author_role |
author |
author2 |
ARAÚJO,RODRIGO BARCELLOS CASTRO,MARIA DO CARMO VALENTE RAMOS,MARIA ROBERTA MENEGUETTI SERAVALLI CUNHA-E-SILVA,JOSÉ ANTONIO IGLESIAS,ANTONIO CARLOS |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
RAMOS,LUIZ PAULO JACOMELLI ARAÚJO,RODRIGO BARCELLOS CASTRO,MARIA DO CARMO VALENTE RAMOS,MARIA ROBERTA MENEGUETTI SERAVALLI CUNHA-E-SILVA,JOSÉ ANTONIO IGLESIAS,ANTONIO CARLOS |
dc.subject.por.fl_str_mv |
Blood Pressure Hemodynamics Echocardiography, Transesophageal Aged Laparoscopy Pneumoperitoneum, Artificial. |
topic |
Blood Pressure Hemodynamics Echocardiography, Transesophageal Aged Laparoscopy Pneumoperitoneum, Artificial. |
description |
ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000200158 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912018000200158 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-6991e-20181659 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões v.45 n.2 2018 reponame:Revista do Colégio Brasileiro de Cirurgiões instname:Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC |
instname_str |
Colégio Brasileiro de Cirurgiões (CBC) |
instacron_str |
CBC |
institution |
CBC |
reponame_str |
Revista do Colégio Brasileiro de Cirurgiões |
collection |
Revista do Colégio Brasileiro de Cirurgiões |
repository.name.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC) |
repository.mail.fl_str_mv |
||revistacbc@cbc.org.br |
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1754209214118494208 |