Gerald S Zavorsky1, Do Jun Kim, Jean-Loup Sylvestre, Nicolas V Christou. 1. Department of Obstetrics, Gynecology and Women's Health, School of Medicine, Saint Mary's Health Center, Saint Louis University, 6420 Clayton Road, Suite 290, Saint Louis, MO 63117, USA. zavorsky@slu.edu
Abstract
BACKGROUND: Morbidly obese individuals may have impaired alveolar-membrane diffusing capacity (DmCO). The purpose of this study was to measure pulmonary diffusing capacity for NO (DLNO) as an index of DmCO pre- and postbariatric surgery in the morbidly obese. METHODS: Twenty-one patients [age = 40 +/- 9 years, body mass index (BMI) = 48.5 +/- 7.2 kg/m2] with an excess weight of 72 +/- 17 kg scheduled for bariatric surgery were recruited. Pulmonary function and arterial blood-gases were measured pre- and postsurgery. RESULTS: DmCO was 88 +/- 23% of predicted before surgery (p < 0.05). There was loss in BMI and excess weight of 7.7 +/- 2.0 kg/m2 and 31 +/- 8%, respectively. Because DmCO = DLNO/2.42, the increase in DLNO postsurgery resulted in a normalization of the predicted DmCO to 97 +/- 29% predicted, or an improvement of DLNO by 11 +/- 18 (95% CI = 3.5, 19.1; p = 0.01) milliliters per minute per millimeter of mercury without any improvement in DLCO. The DLNO/DLCO ratio and alveolar volume both increased, respectively (p < 0.05), and pulmonary capillary blood volume to DmCO ratio decreased postsurgery (p < 0.01). Multiple linear regression revealed that the change in DLNO was most strongly associated with changes in alveolar volume and the waist-to-hip ratio (adjusted r2 = 0.76; p < 0.001) and was not related to the reduction in the alveolar-to-arterial PO2 difference. CONCLUSION: Alveolar-membrane diffusion normalizes within 10 weeks after bariatric surgery. This is likely due to the increase in alveolar volume from the reduction in the waist-to-hip ratio.
BACKGROUND: Morbidly obese individuals may have impaired alveolar-membrane diffusing capacity (DmCO). The purpose of this study was to measure pulmonary diffusing capacity for NO (DLNO) as an index of DmCO pre- and postbariatric surgery in the morbidly obese. METHODS: Twenty-one patients [age = 40 +/- 9 years, body mass index (BMI) = 48.5 +/- 7.2 kg/m2] with an excess weight of 72 +/- 17 kg scheduled for bariatric surgery were recruited. Pulmonary function and arterial blood-gases were measured pre- and postsurgery. RESULTS:DmCO was 88 +/- 23% of predicted before surgery (p < 0.05). There was loss in BMI and excess weight of 7.7 +/- 2.0 kg/m2 and 31 +/- 8%, respectively. Because DmCO = DLNO/2.42, the increase in DLNO postsurgery resulted in a normalization of the predicted DmCO to 97 +/- 29% predicted, or an improvement of DLNO by 11 +/- 18 (95% CI = 3.5, 19.1; p = 0.01) milliliters per minute per millimeter of mercury without any improvement in DLCO. The DLNO/DLCO ratio and alveolar volume both increased, respectively (p < 0.05), and pulmonary capillary blood volume to DmCO ratio decreased postsurgery (p < 0.01). Multiple linear regression revealed that the change in DLNO was most strongly associated with changes in alveolar volume and the waist-to-hip ratio (adjusted r2 = 0.76; p < 0.001) and was not related to the reduction in the alveolar-to-arterial PO2 difference. CONCLUSION: Alveolar-membrane diffusion normalizes within 10 weeks after bariatric surgery. This is likely due to the increase in alveolar volume from the reduction in the waist-to-hip ratio.
Authors: Scott M Grundy; H Bryan Brewer; James I Cleeman; Sidney C Smith; Claude Lenfant Journal: Arterioscler Thromb Vasc Biol Date: 2004-02 Impact factor: 8.311
Authors: Gerald S Zavorsky; Juan M Murias; Do Jun Kim; Jennifer Gow; Jean-Loup Sylvestre; Nicolas V Christou Journal: Chest Date: 2007-02 Impact factor: 9.410
Authors: Sjaak Pouwels; Marieke Kools-Aarts; Mohammed Said; Joep A W Teijink; Frank W J M Smeenk; Simon W Nienhuijs Journal: Springerplus Date: 2015-07-07