Short-Term Respiratory Physical Therapy Treatment in the PACU and Influence on Postoperative Lung Function in Obese Adults

Zoremba, Martin; Dette, Frank; Gerlach, Laura; Wolf, Ursula; Wulf, Hinnerk

doi:10.1007/s11695-009-9922-7

Cited by 33 publications

(21 citation statements)

References 53 publications

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“…71 Zoremba et al 71 found that obese subjects who undertook postoperative incentive spirometry had better pulse oximetry values than controls had upon first mobilization, and that these subjects recovered lung function significantly faster during their time in the postanesthesia care unit.…”

Section: Respiratory Care In the Postanesthesia Care Unit And Postextmentioning

confidence: 99%

Respiratory Management of Perioperative Obese Patients

et al. 2016

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SummaryWith a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique. Although strong evidence and research are lacking regarding how to best ventilate the obese surgical patient, we aim with this review to provide an assessment of the small amount of research that has been conducted and the pathophysiology we believe influences the apparent results. We will provide a basic overview of the anatomy and pathophysiology of the obese respiratory system and review studies concerning pre-, intra-, and postoperative respiratory care. Our focus in this review centers on the best approach to keeping the lung recruited through the prevention of compression atelectasis and the maintaining of physiological lung volumes. We recommend the use of PEEP via noninvasive ventilation (NIV) before induction and endotracheal intubation, the use of both PEEP and periodic recruitment maneuvers during mechanical ventilation, and the use of PEEP via NIV after extubation. It is our hope that by studying the underlying mechanisms that make ventilating obese patients so difficult, future research can be better tailored to address this increasingly important challenge to the field of anesthesia.

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Section: Respiratory Care In the Postanesthesia Care Unit And Postextmentioning

confidence: 99%

Respiratory Management of Perioperative Obese Patients

et al. 2016

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“…124 The intervention was carried out in the PACU following tracheal extubation and consisted of repeated sets of incentive spirometry exercises every 15 min for the first two hours after surgery. The intervention group displayed better oxygen saturation in the PACU and at six and 24 hr postoperatively.…”

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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“…Zoremba et al randomized 60 obese surgical patients to incentive spirometry starting in recovery, versus no incentive spirometry. 109 The incentive spirometry group had significantly improved oxygenation, functional vital capacity, and peek inspiratory flow compared with the control group. This translates into real clinical outcome improvement.…”

Section: Postoperative Carementioning

confidence: 87%

Evidence-Based Strategies to Reduce Postoperative Complications in Plastic Surgery

Harrison

Khansa

Janis

2016

Plastic and Reconstructive Surgery

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Reconstructive plastic surgery is vital in assisting patients with reintegration into society after events such as tumor extirpation, trauma, or infection have left them with a deficit of normal tissue. Apart from performing a technically sound operation, the plastic surgeon must stack the odds in the favor of the patient by optimizing them before and after surgery. The surgeon must look beyond the wound, at the entire patient, and apply fundamental principles of patient optimization. This article reviews the evidence behind the principles of patient optimization that are commonly used in reconstructive surgery patients.

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Short-Term Respiratory Physical Therapy Treatment in the PACU and Influence on Postoperative Lung Function in Obese Adults

Abstract: Short-term respiratory physiotherapy during the PACU stay promotes more rapid recovery of postoperative lung function in the obese during the first 24 h.

Cited by 33 publications

References 53 publications

Respiratory Management of Perioperative Obese Patients

Respiratory Management of Perioperative Obese Patients

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

Evidence-Based Strategies to Reduce Postoperative Complications in Plastic Surgery

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