Laparoscopic procedures are often performed on high risk surgical patients that could benefit from close haemodynamic monitoring and goal directed fluid therapy. Pneumoperitoneum has been shown to influence haemodynamic variables and alter arterial pressure waveform upon which many minimally invasive haemodynamic monitors rely. There are a few individual studies verifying various less invasive haemodynamic devices. With the possible exception of oesophageal Doppler, their measurements under pneumoperitoneum conditions are less reliable. Besides modifying reliability of monitors, pneumoperitoneum possibly also exerts independent influence on haemodynamic variables, such as lowering predictive value of pulse pressure variation for fluid responsiveness.
KEYWORDS: pneumoperitoneum, laparoscopy, haemodynamic monitoring