| Effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in morbidly obese patients receiving laparoscopic gastric banding. | |
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MedLine Citation:
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PMID: 10926070 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A Casati; L Comotti; C Tommasino; C Leggieri; E Bignami; F Tarantino; G Torri |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 17 ISSN: 0265-0215 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2000 May |
Date Detail:
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Created Date: 2000-11-30 Completed Date: 2000-11-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 300-5 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, University of Milan, IRCCS H San Raffaele, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Gas Analysis Blood Gas Monitoring, Transcutaneous Blood Pressure / physiology Body Mass Index Female Hemodynamics / physiology* Humans Laparoscopy* Lung Compliance / physiology Male Middle Aged Obesity, Morbid / complications*, physiopathology Pneumoperitoneum / complications*, physiopathology Posture Preanesthetic Medication Prospective Studies Respiratory Function Tests Respiratory Mechanics / physiology* |
| Comments/Corrections | |
Comment In:
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Eur J Anaesthesiol. 2000 Dec;17(12):786-7
[PMID:
11122314
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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