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BACKGROUND: We conducted this animal study to investigate the cardiopulmonary effects of carbon dioxide pneumothorax during laparoscopic surgery and determine what intervention, if any, is necessary for this phenomenon. METHODS: A swine animal model was used (n = 8). Animals were anesthetized and underwent peritoneal insufflation with carbon dioxide. A laceration was created in the left diaphragm. [pO.sub.2], [pCO.sub.2], oxygen saturation, peak inspiratory pressure (PIP), systolic blood pressure, and heart rate were measured and subjected to statistical analysis. RESULTS: Significant changes were noted in the [pO.sub.2], [O.sub.2] saturation, [pCO.sub.2], and PIP upon creation of the pneumothorax. Trends were also noted in the heart rate and the systolic blood pressure. The physiologic changes could be corrected by noninvasive means and without terminating the procedure. CONCLUSIONS: Carbon dioxide pneumothorax produces reproducible cardiopulmonary changes in laparoscopic surgery. These changes are easily monitored and the resulting cardiopulmonary changes can be treated without invasive means. Am J Surg. 1996;171:464-466.