Metabolic gas exchange during different surgical procedures

Abstract

Summary Surgery performed during general anaesthesia has been shown to induce an increase in oxygen consumption Key wordsOxygen; consumption. Carbon dioxide; elimination. Surgery.Surgical trauma induces changes in both cardiovascular and metabolic variables [l, 21. Alterations in the concentrations of several hormones involved in the metabolic response to surgical trauma have been extensively studied and have been shown to be influenced by both the surgical procedure and the type of anaesthesia [l, 21. However, few studies have evaluated the effect of different types of surgery on metabolic rate, as reflected by changes in oxygen consumption (30,) and carbon dioxide production ( ~c o , ) .Commercially available devices for measurement of metabolic gas exchange allow continuous on-line estimations of 30, and 3c02 [3]. In a recent study Vo, and Vco, were evaluated by continuous measurements during gynaecological procedures [4]. The present investigation was designed to examine the influence of four common surgical operations on 30, and Pco,. The anaesthetic technique was similar for the different types of surgery.Patients and methods Forty-five patients undergoing the following types of operation were studied with ethics committee approval and their informed consent: elective laparotomy (cholecystectomy, hysterectomy, intestinal resection, tuboplasty) (n = 13); emergency laparotomy (appendicitis, sigmoid diverticulitis, bowel strangulation, Meckel's diverticulitis) (n = 10

Sarcopenia and sarcopenic obesity in patients with complex abdominal wall hernias

“…[4][5][6][7]9,26 Given the substantial metabolic requirements for recovery after major abdominal operations, we evaluated whether sarcopenia was associated with adverse outcomes and delays in recovery in these patients. 11,12 To our knowledge, this is the first report exploring the prevalence and implications of sarcopenia in a complex ventral hernia repair (VHR) patient population.…”

“…Given the substantial anabolic requirements for recovery after major abdominal operations, we initiated this study to evaluate the hypothesis that sarcopenia would be associated with adverse outcomes and delays in recovery within this medically complex patient group. 11,12 The main objective of this study was to use CT-based measurements to determine the prevalence of sarcopenia and sarcopenic obesity in this patient population. An additional objective was to determine whether these measurements would be associated with preoperative clinical and laboratory profiles or postoperative recovery and complications.…”

“…[11][12][13] Attention has recently been focused on sarcopenia associated with obesity, an association that is now referred to as an independent entity, ''sarcopenic obesity.'' This condition, attributed to the infiltration of muscle with fat and associated with inflammatory states such as metabolic syndrome, has been linked with poor long-term health outcomes including poor survival after resection of cancer and mortality in cardiovascular disease.…”