Document Detail

Effect of vital capacity manoeuvres on arterial oxygenation in morbidly obese patients undergoing open bariatric surgery.
MedLine Citation:
PMID:  17087847     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Arterial oxygenation may be compromised in morbidly obese patients undergoing bariatric surgery. The aim of this study was to evaluate the effect of a vital capacity manoeuvre (VCM), followed by ventilation with positive end-expiratory pressure (PEEP), on arterial oxygenation in morbidly obese patients undergoing open bariatric surgery. METHODS: Fifty-two morbidly obese patients (body mass index >40 kg m-2) undergoing open bariatric surgery were enrolled in this prospective and randomized study. Anaesthesia and surgical techniques were standardized. Patients were ventilated with a tidal volume of 10 mL kg-1 of ideal body weight, a mixture of oxygen and nitrous oxide (FiO2 = 40%) and respiratory rate was adjusted to maintain end-tidal carbon dioxide at a level of 30-35 mmHg. After abdominal opening, patients in Group 1 had a PEEP of 8 cm H2O applied and patients in Group 2 had a VCM followed by PEEP of 8 cm H2O. This manoeuvre was defined as lung inflation by a positive inspiratory pressure of 40 cm H2O maintained for 15 s. PEEP was maintained until extubation in the two groups. Haemodynamics, ventilatory and arterial oxygenation parameters were measured at the following times: T0 = before application of VCM and/or PEEP, T1 = 5 min after VCM and/or PEEP and T2 = before abdominal closure. RESULTS: Patients in the two groups were comparable regarding patient characteristics, surgical, haemodynamic and ventilatory parameters. In Group 1, arterial oxygen partial pressure (PaO2) and arterial haemoglobin oxygen saturation (SaO2) were significantly increased and alveolar-arterial oxygen pressure gradient (A-aDO2) decreased at T2 when compared with T0 and T1. In Group 2, PaO2 and SaO2 were significantly increased and A-aDO2 decreased at T1 and T2 when compared with T0. Arterial oxygenation parameters at T1 and T2 were significantly improved in Group 2 when compared with Group 1. CONCLUSION: The addition of VCM to PEEP improves intraoperative arterial oxygenation in morbidly obese patients undergoing open bariatric surgery.
V Chalhoub; A Yazigi; G Sleilaty; F Haddad; R Noun; S Madi-Jebara; P Yazbeck
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-11-07
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  24     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-09     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  283-8     Citation Subset:  IM    
Hotel Dieu de France Hospital, Department of Anaesthesia and Critical Care, Beirut, Lebanon.
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MeSH Terms
Analgesics, Non-Narcotic / administration & dosage
Bariatric Surgery / methods*
Blood Gas Analysis / methods
Blood Pressure / physiology
Carbon Dioxide / blood
Heart Rate / physiology
Intubation, Intratracheal / methods
Nitrous Oxide / administration & dosage
Obesity, Morbid / surgery*
Oxygen / blood*
Positive-Pressure Respiration / methods*
Prospective Studies
Respiratory Function Tests / methods
Time Factors
Vital Capacity*
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 10024-97-2/Nitrous Oxide; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

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