Evaluation of renal oxygenization in laparoscopic pediatric surgery by near infrared spectroscopy
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In brief
In brief
This comparative study demonstrates that pneumoperitoneum during pediatric laparoscopy significantly reduces renal oxygen saturation compared to open laparotomy, with effects reversible upon desufflation. The findings suggest NIRS monitoring may be valuable for high-risk pediatric patients undergoing laparoscopic procedures.
Written by the GCMD Library team from the article.
Abstract
Purpose
Increased intraabdominal pressure IAP may reduce renal blood flow (RBF). The study aims to evaluate the pneumoperitoneum effect on RBF by comparing renal regional oxygen saturation index (rSrO2) measured by near-infrared spectroscopy (NIRS) in pediatric patients having laparotomy and laparoscopy.
Methods
Of 58 patients having laparoscopy and laparotomy, 18 were excluded due to renal pathologies, combined open surgical procedures, and administration of inotropic drugs. Hemodynamic parameters and rSrO2 were recorded in laparoscopy (n = 20) and laparotomy (n = 20) groups before induction and with 5 min intervals up to 60 min and at post-extubation.
Results
Decrease in right renal rSrO2 at 45th and 60th min and 30th, 45th and 60th min in left were significant in the laparoscopy group compared to laparotomy group. In the laparoscopy group, reductions at T25, T30, T45, and T60 were significant in both renal rSrO2. Renal rSO2 increased to normal with desufflation.
Conclusion
IAP with pneumoperitoneum may lead to renal hypoxia in children. Renal rSO2 returns to normal with desufflation. Renal NIRS monitorization might be needed in patients with renal parenchymal and vascular pathologies, solitary kidney, and multiorgan pathologies that may affect renal oxygenation.