Search PubMed⌕ Search

PubMed · 7858621

Oliguria during laparoscopic surgery.

Abstract

Oliguria is infrequently viewed as a complication of laparoscopic surgery. The rate of urine output in six healthy patients undergoing laparoscopic surgery was measured during the period of CO2 pneumoperitoneum and for several hours after desufflation. The average hourly urine output during insufflation was 0.30 +/- 0.14 mL/kg despite an average hourly intravenous infusion rate of lactated Ringer's solution of 13.0 +/- 4.0 mL/kg. After release of pneumoperitoneum, urine output increased 467% to 1.7 +/- 1.1 mL/kg per hour. Patients remained hemodynamically unchanged perioperatively. Preoperative and postoperative blood urea nitrogen and creatinine concentrations did not significantly differ. We discuss the potential etiologic factors in the development of oliguria in the setting of the increased intra-abdominal pressure of pneumoperitoneum and the implications of this acute but reversible renal dysfunction.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

D T Chang, A J Kirsch, I S Sawczuk. 1994. Oliguria during laparoscopic surgery.. https://doi.org/10.1089/end.1994.8.349

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Neural basis of a simple behavior: abdominal positioning in crayfish.

Crustaceans have been used extensively as models for studying the nervous system. Members of the Order Decapoda, particularly the larger species such as lobsters and crayfish, have large segmented abdomens that are positioned by tonic flexor and extensor muscles. Importantly, the innervation of these tonic muscles is known in some detail. Each abdominal segment in crayfish is innervated bilaterally by three sets of nerves. The anterior pair of nerves in each ganglion controls the swimmeret appendages and sensory supply. The middle pair of nerves innervates the tonic extensor muscles and the regional sensory supply. The superficial branch of the most posterior pair of nerves in each ganglion is exclusively motor and supplies the tonic flexor muscles of that segment. The extension and flexion motor nerves contain six motor neurons, each of which is different in axonal diameter and thus produces impulses of different amplitude. Motor programs controlling each muscle can be characterized by the identifiable motor neurons that are activated. Early work in this field discovered that specific central interneurons control the abdominal positioning motor neurons. These interneurons were first referred to as "command neurons" and later as "command elements." Stimulation of an appropriate command element causes a complex, widespread output involving dozens of motor neurons. The output can be patterned even though the stimulus to the command element is of constant interval. The command elements are identifiable cells. When a stimulus is repeated in a command element, from either the same individual or from different individuals, the output is substantially the same. This outcome depends upon several factors. First, the command elements are not only identifiable, but they make many synapses with other neurons, and the synapses are substantially invariant. There are separate flexion-producing and extension-producing command elements. Abdominal flexion-producing command elements excite other flexion elements and inhibit extensor command elements. The extension producing elements do the opposite. These interactions insure that interneurons of a particular class (flexion- or extension-producing) synaptically recruit perhaps twenty others of similar output, and that command elements promoting the opposing movements are inhibited. This strong reciprocity and the recruitment of similar command elements give a powerful motor program that appears to mimic behavior.

Abdomen↗

Accuracy of image fusion of normal upper abdominal organs visualized with PET/CT.

Although PET/CT scanners have the potential for precise fused registration of structures visualized on both PET and CT, physiological motion during the acquisition of both studies may alter the appearance of organ shape, size or location. The degree of possible mismatch in abdominal organ size and position between PET and CT has not been evaluated. The aim of this study was to assess the consistency in location and measured size of upper abdominal organs with PET and CT using a combined PET/CT system. Forty-six consecutive inpatients who underwent clinical PET/CT scans for suspected cancer were evaluated. CT and PET images attenuation corrected by both CT and germanium-68 transmission scans were obtained, and we separately determined the location of the top and bottom (height), anterior and posterior margins (thickness), and right and left margins (width) for each organ, including liver, spleen, and bilateral kidneys, using CT and both sets of PET images. Differences between the two modalities in terms of location and measured organ size were investigated. In the upper margin of the liver and lower margin of the spleen, more than 10% of the cases showed a larger discrepancy (>20 mm) between CT-based and Ge-corrected PET-based measurements, although the differences in the positions of the edges were less than 10 mm in most cases. The center of the liver tended to be located cephalad and to the right of the body, and that of the spleen tended to be cephalad and posterior on PET, as compared with CT. Moreover, the center of both kidneys tended to be seen cephalad, posterior, and to the right on PET. The liver appeared slightly larger on PET than CT in thickness (CT vs CT-corrected PET vs Ge-corrected PET = 156 mm vs 162 mm vs 162 mm) and width (186 mm vs 189 mm vs 188 mm). By contrast, the spleen appeared slightly smaller on PET than CT in height (84 mm vs 77 mm vs 80 mm) and width (85 mm vs 81 mm vs 80 mm). A similar tendency was observed in the left kidney (105 mm vs 100 mm vs 99 mm in height, and 64 mm vs 59 mm vs 58 mm in width) and the right kidney (99 mm vs 93 mm vs 93 mm in height, and 64 mm vs 59 mm vs 60 mm in width). These differences between the two modalities were statistically significant ( P<0.05). In conclusion, minor mismatches in location and organ size were found to exist between CT and PET images, in part due to physiological motion. Although these differences could potentially affect the quality of the image registrations, they were generally of a modest nature.

Abdomen↗

Disruption of vitellogenin gene function in adult honeybees by intra-abdominal injection of double-stranded RNA.

BACKGROUND: The ability to manipulate the genetic networks underlying the physiological and behavioural repertoires of the adult honeybee worker (Apis mellifera) is likely to deepen our understanding of issues such as learning and memory generation, ageing, and the regulatory anatomy of social systems in proximate as well as evolutionary terms. Here we assess two methods for probing gene function by RNA interference (RNAi) in adult honeybees. RESULTS: The vitellogenin gene was chosen as target because its expression is unlikely to have a phenotypic effect until the adult stage in bees. This allowed us to introduce dsRNA in preblastoderm eggs without affecting gene function during development. Of workers reared from eggs injected with dsRNA derived from a 504 bp stretch of the vitellogenin coding sequence, 15% had strongly reduced levels of vitellogenin mRNA. When dsRNA was introduced by intra-abdominal injection in newly emerged bees, almost all individuals (96%) showed the mutant phenotype. An RNA-fragment with an apparent size similar to the template dsRNA was still present in this group after 15 days. CONCLUSION: Injection of dsRNA in eggs at the preblastoderm stage seems to allow disruption of gene function in all developmental stages. To dissect gene function in the adult stage, the intra-abdominal injection technique seems superior to egg injection as it gives a much higher penetrance, it is much simpler, and it makes it possible to address genes that are also expressed in the embryonic, larval or pupal stages.

Abdomen↗