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Respiratory mechanics in morbid obese patients with chronic obstructive pulmonary disease and hypertension during pneumoperitoneum

Published online by Cambridge University Press:  12 July 2005

Z. Salihoglu ,
S. Demiroluk  and
Y. Dikmen
Z. Salihoglu
Affiliation:
Istanbul Universitesi, Cerrahpasa Tip Fakultesi, Anestezi Anabilimdali, Istanbul, Turkey
S. Demiroluk
Affiliation:
Istanbul Universitesi, Cerrahpasa Tip Fakultesi, Anestezi Anabilimdali, Istanbul, Turkey
Y. Dikmen
Affiliation:
Istanbul Universitesi, Cerrahpasa Tip Fakultesi, Anestezi Anabilimdali, Istanbul, Turkey
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Abstract

Summary

Background and objective: To evaluate the effects of pneumoperitoneum and the reverse Trendelenburg position on respiratory mechanics and blood-gases in morbid obese patients with chronic obstructive pulmonary disease and hypertension.

Methods: Sixteen morbid obese patients with chronic obstructive pulmonary disease and hypertension were studied. Mean arterial pressure, heart rate, respiratory resistance, dynamic respiratory compliance and peak inspiratory pressures were measured at four time points: 5 min after induction of anaesthesia (T1), 5 min after insufflation of the peritoneum (T2), 5 min after adoption of a 20° reverse Trendelenburg position (T3), and 5 min after deflation of the peritoneum (T4). Arterial blood-gas status was measured at the same measuring points.

Results: Respiratory compliance was 40 ± 12, 28 ± 8, 32 ± 8 and 37 ± 11 mL cmH2O−1 in T1, T2, T3 and T4, respectively. The changes were significant at T2, T3 and T4. Airway resistance and peak inspiratory pressures showed comparable changes throughout the study with that of respiratory compliance. Haemodynamic measurements showed no clinically significant changes in this study.

Conclusions: In morbid obese patients with chronic obstructive pulmonary disease and hypertension, a 20° reverse Trendelenburg position improved respiratory mechanics and oxygenation without any apparent adverse effects on haemodynamics during laparoscopic gastric banding surgery.

Keywords

LUNG DISEASES, OBSTRUCTIVE, chronic obstructive, pulmonary diseaseOBESITY, morbid, obesityPOSTURE, head-up tiltRESPIRATION, lung compliance, respiratory mechanicsVASCULAR DISEASES, hypertension
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 8 , September 2003 , pp. 658 - 661
Copyright
2003 European Society of Anaesthesiology

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