Função pulmonar em doentes obesos submetidos a cirurgia bariátrica

Abstract

Obesity is considered one of the most serious public health problems of the modern world. Because it alters the relationship between the lungs, chest wall and diaphragm, it is to be expected that it impacts on the respiratory function. In Portugal, there is not much data about the relationship between obesity and pulmonary function. The aim of this study was to characterize respiratory function in morbidly obese patients and to evaluate whether weight loss in patients submitted to bariatric surgery affects pulmonary function tests (PFT). We conducted a retrospective study with 36 morbidly obese patients submitted to bariatric surgery, with a mean age of 40.6 years, 64% female and with a mean body mass index (BMI) of 49.7 kg/m². All patients were clinical and functionally evaluated before surgery and after their weight had stabilized following surgery. They underwent a complete pulmonary function testing with spirometry, lung volumes, carbon monoxide diffusing capacity (DLCO), maximum respiratory pressures and arterial blood gases analysis. Prior to surgery almost all the patients had functional respiratory changes, 34 had a decrease in functional residual capacity (FRC) 6 of whom a restrictive syndrome. Only 2 patients did not show any functional or arterial blood gas change. After bariatric surgery, BMI decreased to 34 kg/m² and there was a significant improvement in almost all functional parameters with resolution of restrictive disorders. Nevertheless, in 13 patients the FRC remained decreased. After weight loss, the only correlation found was between reduction of BMI and increased FRC (r = -0.371; p = 0.028). This study suggests a relationship between obesity and pulmonary restriction and a positive impact of bariatric surgery in PFT.

Influence of body mass index and age on the lung function of obese women

“…Guimarães, Martins and Santos, 26 evaluated the lung function of morbidly obese individuals and concluded that obesity influenced ERV and FRC. The authors explained that the reduction of ERV and FRC in obesity occurs due to mechanical changes in the chest wall, a decrease in total respiratory compliance, and reduced lung flow and volume.…”

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

“…The literature reports a reduction of maximum pressure generated by the contraction of the ventilatory muscles due to the biomechanical disadvantage and an increase in respiratory work. The impairment in respiratory mechanics, characterized by a reduction of thoracic compliance due to the buildup of fat, a reduction of tidal volume and a consequent increase in respiratory rate, are positively correlated with the degree of obesity [34,35]. …”

Ventilação Pulmonar E Sua Relação Com Medidas Do Quociente Respiratório E Percentual De Gordura: Estudo Preliminar

“…Indicam também a redução da capacidade ventilatória em indivíduos com elevados níveis de gordura corporal (AGUIAR et al, 2012;BOSON;GARDENGHI, 2012;COSTA et al, 2003;GUIMARÃES;MARTINS;SANTOS, 2012;RASSLAN et al, 2004). Cabe ressaltar que estes estudos avaliaram a função pulmonar utilizando a espirometria e com o avaliado em repouso, enquanto que o trabalho analisou a capacidade cardiorrespiratória através do teste ergoespirométrico, considerando as medidas respiratórias diretas do analisador de gases VO2000.…”

“…A obesidade se caracteriza pelo acúmulo de tecido adiposo acima do recomendado e é considerada uma doença crônica não transmissível (BOSON; GARDENGHI, 2012;GUIMARÃES;MARTINS;SANTOS, 2012;HEYWARD, 2004;SALVE, 2006). As disfunções cardiometabólicas dos obesos, que afetam vários tecidos e/ou sistemas corporais, tornam os sujeitos mais suscetíveis ao desenvolvimento de doenças, como os problemas pulmonares (FRANÇA, 2004;OLIVEIRA et al, 2006;SALVE, 2006;SCIPIONI, 2010, TEIXEIRA et al, 2007.…”