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Recommended insufflating pressure in pediatric laparoscopy

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Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"The insufflation setting is based on the patient’s age and surgeon’s preference. An intraperitoneal pressure of 15 mmHg is usually tolerated by most healthy pediatric patients who weigh more than 5 kg. Intraperitoneal pressures of more than 20 mmHg can lead to decreased venous return and ventilator issues. If the patient is less than 5 kg, an intraperitoneal pressure of 8–12 mmHg is used."

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quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -

"The generally recommended pressures for insufflation are 15 mm Hg in adolescents (>10 years), 10–12 mm Hg in children (2–10 years), and 8–10 mm Hg in infants (0–2 years); these levels produce minimal physiologic effects. Children typically have a smaller and more compliant anterior abdominal wall than adults, limiting the working space during insufflation. Their peritoneal cavity does not accommodate more than 1–2 L of pneumoperitoneum, compared with 3–5 L in adults. Because of the higher compliance of their anterior abdominal wall, increasing the IAP above these recommended levels does not increase the working space."

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