RESUMO
Introducción: es bien sabido que el neumoperitoneo en cirugía laparoscópica afecta tanto al sistema cardiovascular como al sistema respiratorio, pero no se entiende por completo el grado en el que debemos modificar los parámetros ventilatorios para mini-mizar las complicaciones debido a la insuflación del neumoperitoneo. Estos cambios in-cluyen disminución de la distensibilidad y mayores presiones inspiratorias pico.
Abstract Background: it is well known that pneumoperitoneum in laparoscopic surgery affects both cardiovascular and respiratory system, but it is not fully understood yet the degree in which we have to make changes in the ventilatory settings to minimize the complica-tions due to insufflation of peritoneum, changes including impaired compliance and hig-her peak inspiratory.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Pneumoperitônio/cirurgia , Atelectasia Pulmonar/complicações , Ventilação Pulmonar , Pressões Respiratórias Máximas , AnestesiaRESUMO
Both gestation and diabetes mellitus (DM) are conditions associated with an increased participation of renin-angiotensin system (RAS) as well as with changes in the vascular response to angiotensin II (Ang II). We sought to establish the impact of gestational diabetes mellitus (GDM) on Ang II- induced vasoconstriction and its correlation with the expression of angiotensin II receptors (AT(1)R, AT(2) R). Female Wistar rats, virgin, or on day 3 after mating, received randomly streptozotocin (STZ) 60 mg/kgor saline ip.Streptozotocin-treated animals developed hyperglycemia (25.6 ± 1.42 mM). Ang II-induced vasoconstriction was evaluated on isolated aortas with (e+) and without (e-) endothelium and the protein expression of AT(1)R and AT(2)R was measured by western blot. Gestational diabetes mellitus significantly increased vasoconstriction with respect to all the other groups. Changes were observed only on e+ vessels. Interestingly, GDM moved AT(1)R: AT(2)R balance towards AT(1) R, while both pregnancy and diabetes towards AT(2)R expression. In conclusion, GDM increases the possibility of an hypertensive complication by an increased AT(1)R expression.
