Boussignac CPAP in the Postoperative Period in Morbidly Obese Patients

Gaszyński, Tomasz; Tokarz, A.; Piotrowski, Dariusz; Machała, Waldemar

doi:10.1007/s11695-007-9079-1

Cited by 71 publications

(48 citation statements)

References 14 publications

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“…Trials of the use of noninvasive ventilation in patients who underwent lowrisk surgical procedures were generally small and reported only physiologic outcomes or found no difference in endotracheal intubation, hospital mortality or length of stay. 89,91,95,[97][98][99][102][103][104][105][106][107]109,111 The only exception was a recent large trial of continuous positive airway pressure by mask in 468 patients after cardiac surgery. 101 There was a reduction in a composite end point of pulmonary complications (arterial pressure of oxygen/fraction of inspired oxygen < 100, pneumonia or reintubation) and readmission to the ICU or an intermediate care unit.…”

Section: Prevention Of Respiratory Failurementioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

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Section: Prevention Of Respiratory Failurementioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

View full text Add to dashboard Cite

“…Elective tracheal extubation to CPAP or NIV has been shown to improve postoperative oxygenation and offers flexibility where extubation to conventional facemask oxygen would not succeed. 122 This technique can be utilized in the PACU, and the patient can then either electively remain on this therapy or have a trial of weaning over a period of hours. The evidence for use in patients who were not receiving such therapy preoperatively is tenuous, but this approach is logical given the additional physiological insults of surgery.…”

Section: Optimization Of Lung Function and Oxygenationmentioning

confidence: 99%

Perioperative management of the severely obese patient: a selective pathophysiological review

Cullen

Ferguson

2012

Can J Anesth/J Can Anesth

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“…Entretanto Gaszynski 19 considera aumento do trabalho respiratório sinais como retração substernal, utilização da musculatura acessória da inspiração e aparecimento da respiração paradoxal, sinais esses que não foram detectados neste estudo.…”

Section: Discussionunclassified

“…No presente estudo, não se pode afirmar que houve recrutamento alveolar pois, embora o VM tenha aumentado, houve manutenção do VC e, então, somente se pode atribuir ao aumento do VM, o aumento da FR. Segundo Gaszynski 19 , os pacientes devem não só aprender a respirar dentro da máscara como também tolerá-la e, atribui-se a isso o fato do aparecimento da sensação de dispneia e certo desconforto no início da aplicação. Embora não tenha sido avaliada a sensação de dispneia nos pacientes estudados, pode-se constatar aumento da frequência respiratória, o que também pode estar associada à adaptação das pacientes à máscara.…”

Section: Discussionunclassified

Aplicação da pressão positiva contínua nas vias aéreas em pacientes em pós-operatório de cirurgia bariátrica

et al. 2012

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| The objective was to evaluate the effect of continuous positive airway pressure (CPAP) in the respiratory rate (RR), tidal volume (TV) and minute volume (MV) in patients after bariatric surgery. Ten patients with mean age 29.8±8 years, classified as morbidly obese (BMI 47.5±7.2 kg/m 2 ) who received CPAP from 8 to 10 cmH 2 O, for 30 minutes, once a day for two consecutive days, in the post-bariatric surgery were studied. Before and after applying CPAP were measured RR and the MV through the ventilometer, and indirectly the TV were calculated . The Shapito-Wilk was applied to check the normality of data, and then the measures were compared using the Student's t-test and Mann-Whitney test. Analyses were processed using the SPSS 7.5 considering the 5% level of significance. There was a significant increase for the following variables in the first and second days of application: RR=20±6 breathing/min versus 26±7 breathing/min (p=0.009), and RR=22±7 breathing/min versus 26±8 breathing/min (p=0,007); MV=9.57±2.75 L versus 12.39±4.18 L (p=0.041), and MV=9.71±2.52 L versus 11,18±2.96 L (p=0.037). The values of TV=360±157,59 mL versus 440±69,18 mL (p=0,21), and 401±90,46 mL versus 416±78,04 mL (p=0,18) did not differ significantly when comparing pre-and post-application in two days therapy. Thus, it was concluded that CPAP can be applied as an auxiliary respiratory therapy in the treatment of patients in post-bariatric surgery for the RESUMO | O objetivo deste trabalho foi avaliar o efeito da aplicação da pressão positiva contínua nas vias aéreas (CPAP), na frequência respiratória (FR), no volume corrente (VC) e no volume minuto (VM), em pacientes em pós--operatório de cirurgia bariátrica. Foram estudadas dez pacientes com média de idade 29,8±8 anos, classificadas como obesas mórbidas [índice de massa corpórea (IMC) de 47,5±7,2 kg/m 2 ] que receberam CPAP de 8 a 10 cmH 2 O, por 30 minutos, uma vez ao dia, durante dois dias consecutivos, no pós-operatório de cirurgia bariátrica. Antes e após a aplicação da CPAP, foram aferidos a FR e o VM por meio do ventilômetro e, de forma indireta, foi calculado o VC. Para verificar a normalidade dos dados foi aplicado o teste de Shapiro-Wilk, e, após, as medidas foram comparadas com o uso do Teste t de Student e de Man-Whitney. As análises foram processadas com o uso do SPSS 7,5 considerando o nível de 5% de significância. Houve um aumento significativo para as seguintes variáveis estudadas no primeiro e no segundo dia de aplicação: FR=20±6 resp/ min versus 26±7 resp/min (p=0,009) e FR=22±7 resp/ min versus 26±8 resp/min (p=0,007); VM=9,57±2,75 L versus 12,39±4,18 L (p=0,041) e VM=9, 71±2,52 L versus 11,18±2,96 L (p=0,037). Os valores do VC=360±157,59 mL versus 440±69,18 mL (p=0,21) e 401±90,46 mL versus 416±78,04 mL (p=0,18) não apresentaram diferença significativa na comparação pré-e pós-aplicação, nos dois Aplicação da pressão positiva contínua nas vias aéreas em pacientes em pós-operatório de cirurgia bariátrica Applying continuous positive airways pressure in patients...

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Boussignac CPAP in the Postoperative Period in Morbidly Obese Patients

Abstract: Boussignac CPAP improved blood oxygenation compared to passive oxygenation with a nasal catheter but had no influence on CO2 elimination in non-CO2 retaining morbidly obese patients.

Cited by 71 publications

References 14 publications

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Perioperative management of the severely obese patient: a selective pathophysiological review

Aplicação da pressão positiva contínua nas vias aéreas em pacientes em pós-operatório de cirurgia bariátrica

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