Which is a cardiovascular effect of pneumoperitoneum?

Which is a cardiovascular effect of pneumoperitoneum?

• A. Increased preload
• B. Increased afterload
• C. Decreased CO
• D. Increased cardiac output

Answer: (C)

Pneumoperitoneum raises intra-abdominal pressure, which compresses venous return to the heart. This lowers preload, and with less filling the stroke volume drops via the Frank-Starling mechanism. Consequently cardiac output tends to decrease, especially in patients with limited cardiac reserve. While there can be an increase in afterload from higher systemic vascular resistance and hypercarbia, the most consistent cardiovascular effect during insufflation is a reduction in cardiac output due to decreased preload.

Pneumoperitoneum raises intra-abdominal pressure, which compresses venous return to the heart. This lowers preload, and with less filling the stroke volume drops via the Frank-Starling mechanism. Consequently cardiac output tends to decrease, especially in patients with limited cardiac reserve. While there can be an increase in afterload from higher systemic vascular resistance and hypercarbia, the most consistent cardiovascular effect during insufflation is a reduction in cardiac output due to decreased preload.