Background: Laparoscopic surgical interventions are being used in trauma patients for diagnostic
and therapeutic purposes, but there are limited studies on this subject. The effect of pneumoperitoneum
during intra-abdominal hemorrhage has not been elucidated. The aim of this study was to
investigate the hemodynamic, respiratory, and renal effects of pneumoperitoneum in the splenic injury/
hemorrhagic shock model in rats.
Material and Methods: In this study, 80 anesthetized Wistar male rats (294.5 ± 31.2 g) were randomized
into 2 main groups: nontraumatized (group A) and traumatized (group B). After initial
preparation and monitoring, each group was divided according to the degree of pneumoperitoneum.
The nontraumatized subgroups were A1, sham-operated; A2, 4–8 mm Hg; A3, 9–13 mm Hg; and
A4, 14–18 mm Hg. The traumatized subgroups were B1, splenic injury without pneumoperitoneum;
B2, B3, and B4, splenic injury with pneumoperitoneum at 4–8 mm Hg, 9–13 mm Hg, and 14–18 mm
Hg, respectively. Mean arterial pressure, heart rate, and respiratory rate were monitored continuously.
Blood samples were obtained for hemoglobin, hematocrit, arterial blood gases, and biochemical
analyses. Twenty-four hour urine output was collected.
Results: In group B4, pH, pCO2, and HCO3 levels were lower than in all other groups, while pCO2
and base deficit levels were significantly higher (P < 0.05).
Both blood and urine analysis results showed that 24-hour urine output and the glomerular filtration
rate of groups A4 and B4 were significantly lower (P < 0.05), while urinary osmolarity and
fractional sodium excretion levels were significantly higher (P < 0.05).
Conclusion: High-pressure pneumoperitoneum in splenically traumatized rats amplifies acidosis,
decreases urine output, decreases glomerular filtration rate, and increases urinary osmolarity and
fractional sodium excretion significantly.
