Comparison of positive end-expiratory pressure with reverse Trendelenburg position in morbidly obese patients undergoing bariatric surgery: effects on hemodynamics and pulmonary gas exchange.
Obes Surg
; 13(4): 605-9, 2003 Aug.
Article
in En
| MEDLINE
| ID: mdl-12935363
ABSTRACT
BACKGROUND:
Anesthetized morbidly obese patients often exhibit impaired pulmonary gas exchanges, mostly because of a reduction in functional residual capacity. At present, several approaches are suggested to ventilate these patients.METHODS:
The efficiency of positive end-expiratory pressure (PEEP) and reverse Trendelenburg position (RTP) were compared in order to improve oxygenation in 20 morbidly obese patients undergoing bariatric surgery.RESULTS:
Both PEEP and RTP determined a significant decrease in alveolar-arterial oxygen difference and an increase in total respiratory compliance (Ctot). RTP resulted in lower airway pressures than PEEP with similar improvements in Ctot and oxygenation. Concerning hemodynamic parameters, cardiac output (CO) significantly decreased with both PEEP and RTP.CONCLUSIONS:
RTP and PEEP can be considered adequate ventilatory settings for morbidly obese patients, without any significant difference with regard to gas exchange improvement. However, the decrease in CO may partially counteract the beneficial effects on oxygenation of these ventilatory settings.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Obesity, Morbid
/
Biliopancreatic Diversion
/
Pulmonary Gas Exchange
/
Positive-Pressure Respiration
/
Head-Down Tilt
/
Hemodynamics
Type of study:
Etiology_studies
/
Evaluation_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Obes Surg
Journal subject:
METABOLISMO
Year:
2003
Document type:
Article
Affiliation country:
Italia