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Pulmonary changes during laparoscopic and robotic surgery

Pulmonary changes during laparoscopic and robotic surgery
Parameter Change Causes
Lung volume (ie, functional residual capacity) Decrease
  • Elevation of diaphragm
  • Increased intraabdominal pressure
  • Positioning
Lung compliance Decreased
  • Increased pleural pressure
  • Increased airway pressure
  • Elevation of diaphragm
  • Increased intraabdominal pressure
PCO2 Increased, depending on ventilation CO2 absorption
PO2 Variable Interaction among:
  • Atelectasis
  • Hypoxic pulmonary vasoconstriction
  • Preoperative pulmonary status
Tracheal position Cephalad displacement, possible mainstem intubation
  • Increased intraabdominal pressure
  • Trendelenburg position
PO2: partial pressure of oxygen; PCO2: partial pressure of carbon dioxide; CO2: carbon dioxide.
Adapted from: Joshi G, Cunningham A. Anesthesia for laparoscopic and robotic surgeries. In: Clinical Anesthesia, 7th ed, Barash PG, Cullen BF, Stoelting RK, et al (Eds), Lippincott Williams & Wilkins, Philadelphia 2013.
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