Document Detail


Comparison of positive end-expiratory pressure with reverse Trendelenburg position in morbidly obese patients undergoing bariatric surgery: effects on hemodynamics and pulmonary gas exchange.
MedLine Citation:
PMID:  12935363     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
V Perilli; L Sollazzi; C Modesti; M G Annetta; T Sacco; M G Bocci; R M Tacchino; R Proietti
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Obesity surgery     Volume:  13     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-25     Completed Date:  2003-11-19     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  605-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy. perilli.v@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia / adverse effects
Biliopancreatic Diversion*
Female
Head-Down Tilt / physiology*
Hemodynamics / physiology*
Humans
Male
Middle Aged
Obesity, Morbid / physiopathology*,  surgery*
Positive-Pressure Respiration*
Pulmonary Gas Exchange / physiology*
Respiratory Function Tests
Respiratory Insufficiency / etiology,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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