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Effects of CPAP on Gastric Pouch Pressure After Bariatric Surgery.
MedLine Citation:
PMID:  21512817     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine if the routine use of postoperative continuous positive airway pressure (CPAP) in patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) is associated with an increase in transmural gastric pouch pressure, which may create the risk for anastomotic leak. METHODS: Transmural gastric pressures (difference between gastric pouch and bladder pressures) were measured postoperatively [post-anesthesia recovery care unit (PACU) arrival (prior to initiation of CPAP), 5 min, 30 min, and PACU discharge] in 28 patients (19 patients used CPAP, 9 patients did not) following laparoscopic RYGB. Changes in pressure over time were assessed using a generalized estimating equation, taking into account the repeated measurements obtained for each subject. In all cases, two-tailed P values ≤0.05 were considered statistically significant. RESULTS: Among patients that used CPAP, there were no changes in transmural pouch pressure from baseline at any point in time (P = 0.628). However, in patients that did not use CPAP, there was a trend towards increased transmural gastric/pouch pressure (P = 0.053), which could be attributed to a transient decrease in bladder pressure at the 5-min measurement interval. CONCLUSIONS: Application of CPAP did not increase transmural gastric pouch pressure in our bariatric patients; therefore, its use in the post-RYGB patients does not pose a risk for pouch distension, which could lead to the disruption of anastomotic integrity.
Authors:
Toby N Weingarten; Michael L Kendrick; James M Swain; Lavonne M Liedl; Christopher P Johnson; Darrell R Schroeder; Bruce D Johnson; Juraj Sprung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-22
Journal Detail:
Title:  Obesity surgery     Volume:  -     ISSN:  1708-0428     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA, weingarten.toby@mayo.edu.
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