Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem

Details

Serval ID
serval:BIB_396867D8F0B6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem
Journal
Anesthesia and Analgesia
Author(s)
Eichenberger  A., Proietti  S., Wicky  S., Frascarolo  P., Suter  M., Spahn  D. R., Magnusson  L.
ISSN
0003-2999 (Print)
Publication state
Published
Issued date
12/2002
Volume
95
Number
6
Pages
1788-92, table of contents
Notes
Journal Article --- Old month value: Dec
Abstract
Perturbation of respiratory mechanics produced by general anesthesia and surgery is more pronounced in morbidly obese (MO) patients. Because general anesthesia induces pulmonary atelectasis in nonobese patients, we hypothesized that atelectasis formation would be particularly significant in MO patients. We investigated the importance and resorption of atelectasis after general anesthesia in MO and nonobese patients. Twenty MO patients were anesthetized for laparoscopic gastroplasty and 10 nonobese patients for laparoscopic cholecystectomy. We assessed pulmonary atelectasis by computed tomography at three different periods: before the induction of general anesthesia, immediately after tracheal extubation, and 24 h later. Already before the induction of anesthesia, MO patients had more atelectasis, expressed in the percentage of the total lung area, than nonobese patients (2.1% versus 1.0%, respectively; P < 0.01). After tracheal extubation, atelectasis had increased in both groups but remained significantly more so in the MO group (7.6% for MO patients versus 2.8% for the nonobese; P < 0.05). Twenty-four hours later, the amount of atelectasis remained unchanged in the MO patients, but we observed a complete resorption in nonobese patients (9.7% versus 1.9%, respectively; P < 0.01). General anesthesia in MO patients generated much more atelectasis than in nonobese patients. Moreover, atelectasis remained unchanged for at least 24 h in MO patients, whereas atelectasis disappeared in the nonobese. IMPLICATIONS: We compared the resolution over time of pulmonary atelectasis after a laparoscopic procedure by performing computed tomography scans in two different groups of patients: 1 group had 10 nonobese patients, and in the other group there were 20 morbidly obese patients.
Keywords
Adult Atelectasis/*etiology Female Humans Intraoperative Complications/*etiology Laparoscopy Male Middle Aged Obesity, Morbid/*complications Postoperative Complications/*etiology
Pubmed
Web of science
Create date
28/01/2008 11:51
Last modification date
20/08/2019 14:29
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