Changes in Pulmonary Function

Ventilation can be more difficult during laparoscopy due to the cephalad deflection of the diaphragm. The work of breathing is characterized by increasing pulmonary arterial pressures and decreasing tidal volumes, functional residual capacity, and compliance.

The ventilatory rate must be adjusted to avoid systemic acidosis and hypercap-

nia.

Healthy subjects have no change in their pCO2 with 10-15 mm Hg of intraabdominal pressure. The benefit of laparoscopy is less pulmonary embarrassment postoperatively when compared to open procedures. This is demonstrated by improved FVC, FEV1 and peak expiratory flow rates postoperatively. In summary, pulmonary changes are usually well tolerated unless the patient has chronic pulmonary disease in which close monitoring is necessary.

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