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Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit
BACKGROUND: Obese patients frequently develop pulmonary atelectasis upon general anesthesia. The risk is increased during laparoscopic surgery. This prospective, observational single-center study evaluated atelectasis dynamics using Electric Impedance Tomography (EIT) in patients undergoing laparosc...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505733/ https://www.ncbi.nlm.nih.gov/pubmed/37727763 http://dx.doi.org/10.3389/fmed.2023.1233609 |
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author | Braun, Matthias Ruscher, Lea Fuchs, Alexander Kämpfer, Martina Huber, Markus Luedi, Markus M. Riva, Thomas Vogt, Andreas Riedel, Thomas |
author_facet | Braun, Matthias Ruscher, Lea Fuchs, Alexander Kämpfer, Martina Huber, Markus Luedi, Markus M. Riva, Thomas Vogt, Andreas Riedel, Thomas |
author_sort | Braun, Matthias |
collection | PubMed |
description | BACKGROUND: Obese patients frequently develop pulmonary atelectasis upon general anesthesia. The risk is increased during laparoscopic surgery. This prospective, observational single-center study evaluated atelectasis dynamics using Electric Impedance Tomography (EIT) in patients undergoing laparoscopic bariatric surgery. METHODS: We included adult patients with ASA physical status I–IV and a BMI of ≥40. Exclusion criteria were known severe pulmonary hypertension, home oxygen therapy, heart failure, and recent pulmonary infections. The primary outcome was the proportion of poorly ventilated lung regions (low tidal variation areas) and the global inhomogeneity (GI) index assessed by EIT before discharge from the Post Anesthesia Care Unit compared to these same measures prior to initiation of anesthesia. RESULTS: The median (IQR) proportion of low tidal variation areas at the different analysis points were T1 10.8% [3.6–15.1%] and T5 10.3% [2.6–18.9%], and the mean difference was −0.7% (95% CI: −5.8% −4.5%), i.e., lower than the predefined non-inferiority margin of 5% (p = 0.022). There were no changes at the four additional time points compared to T1 or postoperative pulmonary complications during the 14 days following the procedure. CONCLUSION: We found that obese patients undergoing laparoscopic bariatric surgery do not leave the Post Anesthesia Care Unit with increased low tidal variation areas compared to the preoperative period. |
format | Online Article Text |
id | pubmed-10505733 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105057332023-09-19 Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit Braun, Matthias Ruscher, Lea Fuchs, Alexander Kämpfer, Martina Huber, Markus Luedi, Markus M. Riva, Thomas Vogt, Andreas Riedel, Thomas Front Med (Lausanne) Medicine BACKGROUND: Obese patients frequently develop pulmonary atelectasis upon general anesthesia. The risk is increased during laparoscopic surgery. This prospective, observational single-center study evaluated atelectasis dynamics using Electric Impedance Tomography (EIT) in patients undergoing laparoscopic bariatric surgery. METHODS: We included adult patients with ASA physical status I–IV and a BMI of ≥40. Exclusion criteria were known severe pulmonary hypertension, home oxygen therapy, heart failure, and recent pulmonary infections. The primary outcome was the proportion of poorly ventilated lung regions (low tidal variation areas) and the global inhomogeneity (GI) index assessed by EIT before discharge from the Post Anesthesia Care Unit compared to these same measures prior to initiation of anesthesia. RESULTS: The median (IQR) proportion of low tidal variation areas at the different analysis points were T1 10.8% [3.6–15.1%] and T5 10.3% [2.6–18.9%], and the mean difference was −0.7% (95% CI: −5.8% −4.5%), i.e., lower than the predefined non-inferiority margin of 5% (p = 0.022). There were no changes at the four additional time points compared to T1 or postoperative pulmonary complications during the 14 days following the procedure. CONCLUSION: We found that obese patients undergoing laparoscopic bariatric surgery do not leave the Post Anesthesia Care Unit with increased low tidal variation areas compared to the preoperative period. Frontiers Media S.A. 2023-08-29 /pmc/articles/PMC10505733/ /pubmed/37727763 http://dx.doi.org/10.3389/fmed.2023.1233609 Text en Copyright © 2023 Braun, Ruscher, Fuchs, Kämpfer, Huber, Luedi, Riva, Vogt and Riedel. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Braun, Matthias Ruscher, Lea Fuchs, Alexander Kämpfer, Martina Huber, Markus Luedi, Markus M. Riva, Thomas Vogt, Andreas Riedel, Thomas Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title | Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title_full | Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title_fullStr | Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title_full_unstemmed | Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title_short | Atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from Post Anesthesia Care Unit |
title_sort | atelectasis in obese patients undergoing laparoscopic bariatric surgery are not increased upon discharge from post anesthesia care unit |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505733/ https://www.ncbi.nlm.nih.gov/pubmed/37727763 http://dx.doi.org/10.3389/fmed.2023.1233609 |
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