Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study
Abstract Introduction and objectives: The association pneumoperitoneum and obesity in video laparoscopy can contribute to pulmonary complications, but has not been well defined in specific groups of obese individuals. We assessed the effects of pneumoperitoneum in respiratory mechanics in Grade I obese compared to non-obese. Methods: Prospective study including 20 patients submitted to video laparoscopic cholecystectomy, normal spirometry, divided into non-obese (BMI ≤ 25 kg.m-2) and obese (BMI > 30 kg.mg-2), excluding Grade II and III obese. We measured pulmonary ventilation mechanics data before pneumoperitoneum (baseline), and five, fifteen and thirty minutes after peritoneal insufflation, and fifteen minutes after disinflation (final). Results: Mean BMI of non-obese was 22.72 ± 1.43 kg.m-2 and of the obese 31.78 ± 1.09 kg.m-2, p < 0.01. Duration of anesthesia and of peritoneal insufflation was similar between groups. Baseline pulmonary compliance (Crs) of the obese (38.3 ± 8.3 mL.cm H2O-1) was lower than of the non-obese (47.4 ± 5.7 mL.cm H2O-1), p = 0.01. After insufflation, Crs decreased in both groups and remained even lower in the obese at all moments assessed (GLM p < 0.01). Respiratory system peak pressure and plateau pressure were higher in the obese, albeit variations were similar at moments analyzed (GLM p > 0.05). The same occurred with elastic pressure, higher in the obese at all times (GLM p = 0.04), and resistive pressure showed differences in variations between groups during pneumoperitoneum (GLM p = 0,05). Conclusions: Grade I obese presented more changes in pulmonary mechanics than the non-obese during video laparoscopies and the fact requires mechanical ventilation-related care.
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Sociedade Brasileira de Anestesiologia
2020
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oai:scielo:S0034-709420200002000902020-08-07Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal studyAraujo,Orlandira CostaEspada,Eloisa BonettiCosta,Fernanda Magalhães ArantesVigiato,Julia AraujoCarmona,Maria José CarvalhoOtoch,José PinhataSilva Jr.,João ManoelMartins,Milton de Arruda Respiratory mechanics Obese Video laparoscopy Ventilation Compliance Abstract Introduction and objectives: The association pneumoperitoneum and obesity in video laparoscopy can contribute to pulmonary complications, but has not been well defined in specific groups of obese individuals. We assessed the effects of pneumoperitoneum in respiratory mechanics in Grade I obese compared to non-obese. Methods: Prospective study including 20 patients submitted to video laparoscopic cholecystectomy, normal spirometry, divided into non-obese (BMI ≤ 25 kg.m-2) and obese (BMI > 30 kg.mg-2), excluding Grade II and III obese. We measured pulmonary ventilation mechanics data before pneumoperitoneum (baseline), and five, fifteen and thirty minutes after peritoneal insufflation, and fifteen minutes after disinflation (final). Results: Mean BMI of non-obese was 22.72 ± 1.43 kg.m-2 and of the obese 31.78 ± 1.09 kg.m-2, p < 0.01. Duration of anesthesia and of peritoneal insufflation was similar between groups. Baseline pulmonary compliance (Crs) of the obese (38.3 ± 8.3 mL.cm H2O-1) was lower than of the non-obese (47.4 ± 5.7 mL.cm H2O-1), p = 0.01. After insufflation, Crs decreased in both groups and remained even lower in the obese at all moments assessed (GLM p < 0.01). Respiratory system peak pressure and plateau pressure were higher in the obese, albeit variations were similar at moments analyzed (GLM p > 0.05). The same occurred with elastic pressure, higher in the obese at all times (GLM p = 0.04), and resistive pressure showed differences in variations between groups during pneumoperitoneum (GLM p = 0,05). Conclusions: Grade I obese presented more changes in pulmonary mechanics than the non-obese during video laparoscopies and the fact requires mechanical ventilation-related care.info:eu-repo/semantics/openAccessSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia v.70 n.2 20202020-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000200090en10.1016/j.bjane.2020.02.004 |
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Araujo,Orlandira Costa Espada,Eloisa Bonetti Costa,Fernanda Magalhães Arantes Vigiato,Julia Araujo Carmona,Maria José Carvalho Otoch,José Pinhata Silva Jr.,João Manoel Martins,Milton de Arruda |
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Araujo,Orlandira Costa Espada,Eloisa Bonetti Costa,Fernanda Magalhães Arantes Vigiato,Julia Araujo Carmona,Maria José Carvalho Otoch,José Pinhata Silva Jr.,João Manoel Martins,Milton de Arruda Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
author_facet |
Araujo,Orlandira Costa Espada,Eloisa Bonetti Costa,Fernanda Magalhães Arantes Vigiato,Julia Araujo Carmona,Maria José Carvalho Otoch,José Pinhata Silva Jr.,João Manoel Martins,Milton de Arruda |
author_sort |
Araujo,Orlandira Costa |
title |
Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
title_short |
Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
title_full |
Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
title_fullStr |
Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
title_full_unstemmed |
Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
title_sort |
impact of grade i obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study |
description |
Abstract Introduction and objectives: The association pneumoperitoneum and obesity in video laparoscopy can contribute to pulmonary complications, but has not been well defined in specific groups of obese individuals. We assessed the effects of pneumoperitoneum in respiratory mechanics in Grade I obese compared to non-obese. Methods: Prospective study including 20 patients submitted to video laparoscopic cholecystectomy, normal spirometry, divided into non-obese (BMI ≤ 25 kg.m-2) and obese (BMI > 30 kg.mg-2), excluding Grade II and III obese. We measured pulmonary ventilation mechanics data before pneumoperitoneum (baseline), and five, fifteen and thirty minutes after peritoneal insufflation, and fifteen minutes after disinflation (final). Results: Mean BMI of non-obese was 22.72 ± 1.43 kg.m-2 and of the obese 31.78 ± 1.09 kg.m-2, p < 0.01. Duration of anesthesia and of peritoneal insufflation was similar between groups. Baseline pulmonary compliance (Crs) of the obese (38.3 ± 8.3 mL.cm H2O-1) was lower than of the non-obese (47.4 ± 5.7 mL.cm H2O-1), p = 0.01. After insufflation, Crs decreased in both groups and remained even lower in the obese at all moments assessed (GLM p < 0.01). Respiratory system peak pressure and plateau pressure were higher in the obese, albeit variations were similar at moments analyzed (GLM p > 0.05). The same occurred with elastic pressure, higher in the obese at all times (GLM p = 0.04), and resistive pressure showed differences in variations between groups during pneumoperitoneum (GLM p = 0,05). Conclusions: Grade I obese presented more changes in pulmonary mechanics than the non-obese during video laparoscopies and the fact requires mechanical ventilation-related care. |
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Sociedade Brasileira de Anestesiologia |
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2020 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000200090 |
work_keys_str_mv |
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