Transesophageal Doppler ultrasonography evaluation of hemodynamic changes during videolaparoscopic cholecystectomy

Background. The aim of this study was to assess the changes of hemodynamic and oxyphoretic parameters induced by pneumoperitoncum in a series of patients undergoing laparoscopic cholecystectomy, by using the transesophageal Doppler ultrasonography (TEDU). Methods. Design: prospective study. Setting: a medicosurgical intensive care unit of an University Hospital. Patients: 11 patients who underwent laparoscopic cholecystectomy because of gallbladder stones. Interventions: a central venous line, a radial artery line were placed before the induction of anesthesia. End expiratory CO2 (EtCO 2) was monitored by using a capnometer (Dräger, Germany). Cardiac output (CO) was measured using the transesophagcal Doppler system Abbott ODM II (Abbott Critical Care Systems, Ireland), which was positioned in the esophagus after stabilization of anesthesia. Measurements: hemodinamic parameters, including CO, central venous pressure, mean arterial pressure, measurement of EtCO2 and aterial and central venous samples were performed: after reaching a stable anesthesia but before any surgical manipulation (T0); after induction of pneumoperitoneum (T1); 15 min after T1 (T2); 30 min after Tl (T3). Results. SVR increased significantly at Tl and T2 compared to T0; PaCO2 and PvCO2 at T2 and T3. HR and MAP increas?.