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Effects of Variable Ventilation on Gas Exchange in an Experimental Model of Capnoperitoneum: A Randomized Crossover Study.

Anesth Analg

January 2025

From the Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University of Geneva, Geneva, Switzerland.

Background: The rapid advancement of minimally invasive surgical techniques has made laparoscopy a preferred alternative because it reduces postoperative complications. However, inflating the peritoneum with CO2 causes a cranial shift of the diaphragm decreasing lung volume and impairing gas exchange. Additionally, CO2 absorption increases blood CO2 levels, further complicating mechanical ventilation when the lung function is already compromised.

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Mean middle cerebral artery velocity (MCAv) and the pulsatility index (PI), at rest and in response to exercise, are important markers of cerebrovascular health status in middle-aged adults, when vascular decline assumes substantial relevance. Thus, this study aimed to describe and compare the responses of MCAv and PI to incremental exercise. Two hundred and forty-eight volunteers (50-58 years, 55% women) completed a ramp test on a cycle-ergometer.

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Aims: Left ventricular (LV) diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF) are common cardiac complications of patients with systemic sclerosis (SSc). Exercise stress echocardiography is often used in symptomatic patients with SSc to detect abnormal increases in pulmonary pressures during exercise, but the pathophysiologic and prognostic significance of exercise stress echocardiography to assess the presence of HFpEF in these patients is unclear.

Methods And Results: Patients with SSc (n=140) underwent ergometry exercise stress echocardiography with simultaneous expired gas analysis.

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Background: Despite the physiological advantages of positive end-expiratory pressure (PEEP), its optimal utilization during one-lung ventilation (OLV) remains uncertain. We aimed to investigate whether individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV.

Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials until April 1, 2024, to identify published randomized controlled trials that compared individualized PEEP titration by lung compliance with fixed PEEP during OLV.

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Objective: Laparoscopic cholecystectomy is a common procedure for gallbladder diseases, but many patients experience shoulder pain due to pneumoperitoneum. This study investigates the comparative effectiveness of warm carbon dioxide gas insufflation versus local heat application in reducing shoulder pain after laparoscopic cholecystectomy. We also examined changes in body temperature during surgery and postoperative shivering in the intervention and control groups.

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