Key result
Increased intra-abdominal pressure during laparoscopic cholecystectomy decreased cardiac output by 11.29%, mean arterial blood pressure by 9.31%, and systemic vascular resistance by 23.16%.
Why the study?
Increased intra-abdominal pressure, autonomic reactions, and anesthetics contribute to hemodynamic alterations during laparoscopic cholecystectomy, necessitating noninvasive measurement of intraoperative individual cardiac and systemic hemodynamic responses.
Does non-invasive cardiac output monitoring with electrical cardiometry detect significant hemodynamic changes during laparoscopic cholecystectomy?
Cross-Sectional (n=73)
Does non-invasive cardiac output monitoring with electrical cardiometry detect significant hemodynamic changes during laparoscopic cholecystectomy?
Effect estimate: CO -11.29%, MABP -9.31%, SVR -23.16%
Electrical cardiometry enables real-time detection of significant intraoperative hemodynamic changes during laparoscopic cholecystectomy that may be missed by conventional monitoring.
EC captures individual hemodynamic shifts during laparoscopic cholecystectomy; leaves open its role for guiding management in prospective trials.
Background: Increased intra-abdominal pressure (IAP), autonomic reactions, and anesthetics all contribute to hemodynamic alterations during laparoscopic cholecystectomy. This study’s objectives are to measure noninvasively the intraoperative individual responses in cardiac and systemic hemodynamics, focusing on cardiac output (CO. L/min), stroke volume (SV, mL/min), systemic vascular resistance (SVR, dyn.s.cm−5), and noninvasive mean arterial blood pressure (MABP, mmHg) during and after peritoneal insufflation (cmH2O). The secondary objective was to evaluate the utility of EC as an adjunct to standard monitoring and to assess the individual differences. Methods: The CO and associated parameters were continuously and noninvasively monitored with the electrical cardiometry (EC, ICON, Osypka, Berlin Germany). Results: Seventy-three patients showed that when the IAP increased to 13 [IQR: 13-14] cmH2O, there was an overall percentage decrease in CO (−11.29%), MABP (−9.31%), and SVR (−23.16%) compared to pre induction with minimal changes in heart rate (HR). Individual variation and extreme reactions among certain patients were noted, with CO falling by −47.14% and MABP by −61.59, respectively, which can have major repercussions. Conclusions: The EC enabled real-time, non-invasive CO monitoring and detected significant cardio-hemodynamic changes that conventional monitors could miss. EC can supplement traditional monitors and give attending anesthesiologists access to more of patients’ vital information.
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Yassen et al. (2025) conducted a cross-sectional in laparoscopic cholecystectomy (n=73). Increased intra-abdominal pressure (peritoneal insufflation) vs. Pre-induction baseline was evaluated on Changes in cardiac output (CO), mean arterial blood pressure (MABP), and systemic vascular resistance (SVR) (CO -11.29%, MABP -9.31%, SVR -23.16%). Increased intra-abdominal pressure during laparoscopic cholecystectomy decreased cardiac output by 11.29%, mean arterial blood pressure by 9.31%, and systemic vascular resistance by 23.16%.
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