Comparison of positive end-expiratory pressure with reverse Trendelenburg position in morbidly obese patients undergoing bariatric surgery: Effects on hemodynamics and pulmonary gas exchange

Valter Perilli, Liliana Sollazzi, Cristina Modesti, Maria Giuseppina Annetta, Teresa Sacco, Maria Grazia Bocci, Roberto Maria Tacchino, Rodolfo Proietti

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

56 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)605-609
Numero di pagine5
RivistaObesity Surgery
Volume13
DOI
Stato di pubblicazionePubblicato - 2003

Keywords

  • Adult
  • Anesthesia
  • Bariatric surgery
  • Biliopancreatic Diversion
  • Biliopancreatic diversion
  • Female
  • Head-Down Tilt
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Morbid obesity
  • Obesity, Morbid
  • PEEP
  • Positive-Pressure Respiration
  • Pulmonary Gas Exchange
  • Respiratory Function Tests
  • Respiratory Insufficiency
  • Reverse Trendelenburg position
  • Surgery

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