Reading: Management of Mechanical Ventilation in Laparoscopic Surgery

Question 1

How does abd insufflation of gas during laparoscopic surgery affect intra-operative respiratory mechanics?

Answer 1

The upward shift of the diaphragm causes lung volumes to decrease, FRC decreases, thus reducing the reserve volume for O2. The decrease of lung volume towards less compliant regions the tendency of the lung to collapse and form atelectasis. Plus, the pressure of the gases used in laparoscopy (10-12 mmHg) stiffens the diaphragm as well as the chest wall causing a profound rightward shift in the pressure-volume curve of the respiratory system.

Question 2

Define airway resistance

Answer 2

The difference between peak and plateau pressure

Question 3

How do you calculate elastic property?

Answer 3

plateau pressure - PEEP

Question 4

Define pneumoperitoneum

Answer 4

Presence of air or gas in the abd (peritoneal cavity)