BACKGROUND AND OBJECTIVES: Pulmonary complications in bariatric surgery are common and, therefore, alveolar recruitment maneuvers (ARM) have been used to prevent or reduce them in the postoperative period (POP). The aim of this study was to evaluate the impact of ARM performed intraoperatively in patients undergoing bariatric surgery byvideolaparoscopy in the incidence of postoperative pulmonary complications. METHODS: Randomized clinical trial with 30 patients divided intocontrol group (CG) and experimental group (EG), with analysis of spirometric, ventilatory, hemodynamic, and radiographic variables. ARM was performed in EG with positive end expiratory pressure of 30 cmH₂O and inspiratory plateau pressure of 45 cmH₂O for 2 minutes after pneumoperitoneum deflation. RESULTS: We observed a significant decrease in spirometric values (p ≤ 0.001) and higher incidence of pulmonary complications on chest radiograph (p=0.02) in CG, as well as significant improvement in dyspnoea Borg scale (p ≤ 0.001) in EG. CONCLUSIONS: We conclude that ARM is a safe and effective technique when used for prevention of pulmonary complications in patients undergoing bariatric surgery, resulting in more favorable radiological and spirometric findings in the experimental group compared to the control group in the PO.
RCT Entities:
BACKGROUND AND OBJECTIVES:Pulmonary complications in bariatric surgery are common and, therefore, alveolar recruitment maneuvers (ARM) have been used to prevent or reduce them in the postoperative period (POP). The aim of this study was to evaluate the impact of ARM performed intraoperatively in patients undergoing bariatric surgery by videolaparoscopy in the incidence of postoperative pulmonary complications. METHODS: Randomized clinical trial with 30 patients divided into control group (CG) and experimental group (EG), with analysis of spirometric, ventilatory, hemodynamic, and radiographic variables. ARM was performed in EG with positive end expiratory pressure of 30 cmH₂O and inspiratory plateau pressure of 45 cmH₂O for 2 minutes after pneumoperitoneum deflation. RESULTS: We observed a significant decrease in spirometric values (p ≤ 0.001) and higher incidence of pulmonary complications on chest radiograph (p=0.02) in CG, as well as significant improvement in dyspnoea Borg scale (p ≤ 0.001) in EG. CONCLUSIONS: We conclude that ARM is a safe and effective technique when used for prevention of pulmonary complications in patients undergoing bariatric surgery, resulting in more favorable radiological and spirometric findings in the experimental group compared to the control group in the PO.
Authors: Luiz Alberto Forgiarini Júnior; Juliana Castilhos Rezende; Soraia Genebra Ibrahim Forgiarini Journal: Rev Bras Ter Intensiva Date: 2013 Oct-Dec
Authors: Letícia Baltieri; Laisa Antonela Santos; Irineu Rasera; Maria Imaculada Lima Montebelo; Eli Maria Pazzianotto-Forti Journal: Arq Bras Cir Dig Date: 2014