Adverse effects of pneumoperitoneum on renal function: involvement of the endothelin and nitric oxide systems

摘要

pneumoperitoneum at pressure above 10 miiiHg during lapa-roscopic surgery has been shown to produce transient oliguria and reduced glomerular filtration rate (GFR) and renal blood flow (RBF) (3, 9, 16, 33, 34). Despite much research in this field, the systemic physiological consequences of CO2 pneumoperitoneum and the mechanisms underlying its adverse effects on renal hemodynamics and excretory function are not fully understood (9). However, there is compelling experimental evidence that the adverse renal effects induced by pneumoperitoneum are affected by the level of intra-abdominal pressure (IAP), volume status, degree of hypercarbia, positioning, and individual hemodynamic and renal reserves (9, 10).