Effect Of Intra-abdominal Pressure Rise On Hematological Parameters In Laparoscopic Urologic Surgery

OBJECTIVE: To determine the potential utility of hematological parameters in the diagnosis of intra-abdominal hypertension (IAH). STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey, from January 2016 to July 2017. METHODOLOGY: Forty-two patients who underwent transperitoneal laparoscopic urologic surgery were included. Blood samples were obtained during periods of pre-insufflation, insufflation, and desufflation to determine the effects of increased intraabdominal pressure (IAP) on hematological parameters, respectively. RESULTS: Leukocyte and neutrophil median values changed with time (p<0.001). The median pre-insufflation, insufflation, and desufflation values for leukocytes were 6.3 fL (4.2-7.8 fL), 7.2 fL (4.4-9.9 fL), and 8.1 fL (4.9-13.5 fL), respectively. In the pre-insufflation period, the median value for neutrophils was 3.7 x 103 µL (2.0-6.2 x 103 µL), increasing 5.1 x 103 µL (2.1-9.7 x 103 µL) during insufflation and 6.1 × 103 µL (3.1-10.0 x 103 µL) during desufflation. The median values obtained in pre-insufflation period were significantly lower than those recorded in the other periods. There was no difference between the median values obtained during insufflation and those obtained during desufflation. The mean platelet volume (MPV) values during pre-insufflation, insufflation, and desufflation were 8.2 fL (6.3-9.6 fL), 8.8 (6.2-10.3 fL), and 8.1 (6.6-10.6 fL), respectively. There was a statistically significant increase in MPV values during high IAP (p<0.001). CONCLUSION: The rise in MPV during IAP rise indicated that this parameter may be used to detect IAH.