Document Detail

Effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in morbidly obese patients receiving laparoscopic gastric banding.
MedLine Citation:
PMID:  10926070     Owner:  NLM     Status:  MEDLINE    
We prospectively evaluated the effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in 20 ASA physical status II-III morbidly obese patients (body mass index > 35 kg m(-2)) undergoing laparoscopic gastric banding. After general anaesthesia was induced, patients' lungs were ventilated using intermittent positive pressure ventilation (at measurement times, the following parameters were used: tidal volume 12 mL kg(-1) ideal body weight, respiratory rate of 12 bpm, an inspiratory to expiratory time ratio of 1:2). Haemodynamic variables, blood gas parameters, and lung/chest compliance were recorded: in the supine position, after induction of general anaesthesia (T0, baseline) and induction of pneumoperitoneum (T1); after placing the patient in a 25 degree reverse Trendelenburg position (T2); during the surgical time (T3); before deflating the abdomen (T4); after pneumoperitoneum resolution (T5), and before the end of anaesthesia, with the patient supine (T6). The PaO2, PaO2/FiO2 ratio, and lung/chest compliance decreased during the study. After the pneumoperitoneum had been resolved, lung/chest compliance but not oxygenation parameters returned to baseline values. The arterial to end-tidal CO2 tension difference progressively increased from 0.38+/-0.3 kPa (2.85+/-2.25 mmHg) (T0) to 0.63+/-0.3 kPa (4.73+/-2.25 mmHg) (T6). In morbidly obese patients, undergoing laparoscopic gastric banding, a CO2 pneumoperitoneum markedly affected gas exchange and lung/chest compliance, while positioning the patient in a 25 degree reverse Trendelenburg position had no beneficial effects.
A Casati; L Comotti; C Tommasino; C Leggieri; E Bignami; F Tarantino; G Torri
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  17     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-11-30     Completed Date:  2000-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  300-5     Citation Subset:  IM    
Department of Anaesthesiology, University of Milan, IRCCS H San Raffaele, Italy.
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MeSH Terms
Blood Gas Analysis
Blood Gas Monitoring, Transcutaneous
Blood Pressure / physiology
Body Mass Index
Hemodynamics / physiology*
Lung Compliance / physiology
Middle Aged
Obesity, Morbid / complications*,  physiopathology
Pneumoperitoneum / complications*,  physiopathology
Preanesthetic Medication
Prospective Studies
Respiratory Function Tests
Respiratory Mechanics / physiology*
Comment In:
Eur J Anaesthesiol. 2000 Dec;17(12):786-7   [PMID:  11122314 ]

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

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