Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem

Détails

ID Serval
serval:BIB_396867D8F0B6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem
Périodique
Anesthesia and Analgesia
Auteur⸱e⸱s
Eichenberger  A., Proietti  S., Wicky  S., Frascarolo  P., Suter  M., Spahn  D. R., Magnusson  L.
ISSN
0003-2999 (Print)
Statut éditorial
Publié
Date de publication
12/2002
Volume
95
Numéro
6
Pages
1788-92, table of contents
Notes
Journal Article --- Old month value: Dec
Résumé
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.
Mots-clé
Adult Atelectasis/*etiology Female Humans Intraoperative Complications/*etiology Laparoscopy Male Middle Aged Obesity, Morbid/*complications Postoperative Complications/*etiology
Pubmed
Web of science
Création de la notice
28/01/2008 10:51
Dernière modification de la notice
20/08/2019 13:29
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