{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:28:23Z","timestamp":1761017303068,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T00:00:00Z","timestamp":1589328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Capnoperitoneum during laparoscopy leads to cranial shift of the diaphragm, loss in lung volume, and risk of impaired gas exchange. Infants are susceptible to these changes and bedside assessment of lung volume during laparoscopy might assist with optimizing the ventilation. Thus, the primary aim was to investigate the monitoring value of a continuous end\u2010expiratory lung volume (EELV) assessment method based on CO<jats:sub>2<\/jats:sub> dynamics (\n\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aas13607-math-0001.png\" xlink:title=\"urn:x-wiley:00015172:media:aas13607:aas13607-math-0001\"\/>) in a pediatric capnoperitoneum model by evaluating the correlation and trending ability against helium washout (EELV<jats:sub>He<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Intra\u2010abdominal pressure (IAP) was randomly varied between 0, 6, and 12\u00a0mm\u00a0Hg with CO<jats:sub>2<\/jats:sub> insufflation, while positive end\u2010expiratory pressure (PEEP) levels of 3, 6, and 9\u00a0cm H<jats:sub>2<\/jats:sub>O were randomly applied in eight anesthetized and mechanically ventilated chinchilla rabbits. Concomitant \n\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aas13607-math-0002.png\" xlink:title=\"urn:x-wiley:00015172:media:aas13607:aas13607-math-0002\"\/> and EELV<jats:sub>He<\/jats:sub> and lung clearance index (LCI) were obtained under each experimental condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant correlations were found between \n\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aas13607-math-0003.png\" xlink:title=\"urn:x-wiley:00015172:media:aas13607:aas13607-math-0003\"\/> and EELV<jats:sub>He<\/jats:sub> before capnoperitoneum (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.85, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), although increased IAP distorted this relationship. The negative influence of IAP was counteracted by the application of PEEP 9, which restored the correlation between \n\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aas13607-math-0004.png\" xlink:title=\"urn:x-wiley:00015172:media:aas13607:aas13607-math-0004\"\/> and EELV<jats:sub>He<\/jats:sub> and resulted in 100% concordance rate between the methods regarding changes in lung volume. EELV<jats:sub>He<\/jats:sub> and LCI showed a curvilinear relationship, and an EELV<jats:sub>He<\/jats:sub> of approximately 20\u00a0mL\u00a0kg<jats:sup>\u22121<\/jats:sup>, determined with a receiver operating characteristic curve, was associated with near\u2010normal LCI values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this animal model of pediatric capnoperitoneum, reliable assessment of changes in EELV based on \n\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/aas13607-math-0005.png\" xlink:title=\"urn:x-wiley:00015172:media:aas13607:aas13607-math-0005\"\/> requires an open lung strategy, defined as EELV above approximately 20\u00a0mL\u00a0kg<jats:sup>\u22121<\/jats:sup>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13607","type":"journal-article","created":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T05:37:20Z","timestamp":1587447440000},"page":"1106-1113","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["End\u2010expiratory lung volume assessment using helium and carbon dioxide in an experimental model of pediatric capnoperitoneum"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-0092","authenticated-orcid":false,"given":"Jacob","family":"Karlsson","sequence":"first","affiliation":[{"name":"Department of Physiology and Pharmacology (FYFA) Eriksson I Lars group\u2010Section of Anesthesiology and Intensive Care Karolinska Institute Stockholm Sweden"},{"name":"Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital Stockholm 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