The Effect of Positive End Expiratory Pressure on Reduction of Respiratory Complications during and after the Surgery in Patients undergoing Laparoscopic Bariatric Surgery

Document Type : Original Article (s)

Authors

1 Resident, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to determine the effect of positive end expiratory pressure (PEEP) on reduction of respiratory complications during and after the surgery in patients undergoing laparoscopic bariatric surgery.Methods: In a clinical trial study performed in Alzahra hospital, Isfahan, Iran, during 2018-19, 54 patients with severe obesity were selected and allocated in two groups of laparoscopic bariatric surgery with and without PEEP (10 cmH2O). The incidence of respiratory complications and hemodynamic status of patients before, during, and after surgery were evaluated and compared.Findings: The use of PEEP in laparoscopic bariatric surgery decreased the time of hospitalization in intensive care unit (ICU) and general ward, increased oxygenation saturation during surgery and recovery, and improved the number of breathing. The use of PEEP was helpful in preventing respiratory distress, too.Conclusion: According to the results of this study, it can be concluded that PEEP, as a medical aid, can be useful in reducing respiratory complications after laparoscopic bariatric surgery.

Keywords

References

  1. Magrina JF. Complications of laparoscopic surgery. Clin Obstet Gynecol 2002; 45(2): 469-80.
  2. Lujan JA, Frutos MD, Hernandez Q, Liron R, Cuenca JR, Valero G, et al. Laparoscopic versus open gastric bypass in the treatment of morbid obesity: A randomized prospective study. Ann Surg 2004; 239(4): 433-7.
  3. Rouby JJ, Monsel A, Lucidarme O, Constantin JM. Trendelenburg position and morbid obesity: A respiratory challenge for the anesthesiologist. Anesthesiology 2019; 131(1): 10-3.
  4. Monteforte MJ, Turkelson CM. Bariatric surgery for morbid obesity. Obes Surg 2000; 10(5): 391-401.
  5. Coussa M, Proietti S, Schnyder P, Frascarolo P, Suter M, Spahn DR, et al. Prevention of atelectasis formation during the induction of general anesthesia in morbidly obese patients. Anesth Analg 2004; 98(5): 1491-5.
  6. Duggan M, Kavanagh BP. Pulmonary atelectasis: A pathogenic perioperative entity. Anesthesiology 2005; 102(4): 838-54.
  7. Azab TO, El-Masry A, Salah M, Azab AO. Effects of intraoperative use of positive end expiratory pressure on lung atelectasis during laparoscopic cholecystectomy. Egypt J Anaesth 2005; 21(3): 219-25.
  8. DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med 2007; 356(21): 2176-83.
  9. Wheeler AP, Bernard GR. Acute lung injury and the acute respiratory distress syndrome: A clinical review. Lancet 2007; 369(9572): 1553-64.
  10. Moradi B, Teymouri H, Porya A, Khademi M, Ebrahimzadeh F. The effect of two different levels of positive end expiratory pressure (PEEP) in the incidence of atelectasis after coronary artery bypass graft surgery. Yafteh 2017; 19(2): 82-92. [In Persian].
  11. Hashemi ST, Mohammadi-Farsani Z. Short-term outcomes of bariatric surgery in patients with obesity. J Isfahan Med Sch 2018; 35(453): 1521-5. [In Persian].
  12. de Souza AP, Buschpigel M, Mathias LAST, Malheiros CA, Alves VLS. Analysis of the effects of the alveolar recruitment maneuver on blood oxygenation during bariatric surgery. Braz J Anesthesiol 2009; 59(2): 177-86. [In Portuguese].
  13. Schumann R. Anaesthesia for bariatric surgery. Best Pract Res Clin Anaesthesiol 2011; 25(1): 83-93.
  14. Talab H, Zabani I, Abdelrahman H, Bukhari W, Mamoun I, Ashour M, et al. Intraoperative ventilatory strategies for prevention of pulmonary atelectasis in obese patients undergoing laparoscopic bariatric surgery. Anesth Analg 2009; 109(5): 1511-6.
Journal of Isfahan Medical School
Volume 37, Issue 555 - Serial Number 555
November and December 2020
Pages 1333-1337

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History

  • Receive Date: 25 September 2019
  • Revise Date: 30 May 2024
  • Accept Date: 06 April 2022

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