The impact of intraabdominal pressure on the gas-exchange and mechanics of respiration in patients, suffering morbid obesity, while conduction of artificial pulmonary ventilation
Objective. To improve the results of artificial pulmonary ventilation in patients, suffering morbid obesity.
Materials and methods. For this investigation 81 patients were included, in whom bariatric operations, using open surgical access, were performed. While the operative intervention doing the intraabdominal pressure level (IPL) was monitored, as well as partial tension of oxygen in arterial blood (PaO2), median arterial pressure (MAP), and the abdominal perfusion pressure (APP) calculated. Dependence between APP and PaO2 was determined.
Results. After intubation the level of PaO2 have constituted in the patients (86,9 ± 24,1) mm Hg at average, after performance of laparotomy - (121,3 ± 25,2) mm Hg, after closure of the abdominal cavity - from 60,7 to 92 mm Hg, (69,8 ± 9,7) mm Hg at average. The IPL before the abdominal cavity opening have constituted (18,3 ± 1,8) mm Hg at average, after performance of laparotomy it have lowered down to 15,1 ± 2,5 mm Hg at average, and after the abdominal cavity closure it have raised up from the initial level to (21,3 ± 2,4) mm Hg. Direct proportional dependence exists between the APP level and PaO2 (ρ = 0,01, p < 0,05).
Conclusion. The PaO2 level depends directly proportionally on the APP level. IPL in patients, suffering morbid obesity, constitutes one of the factors for the intraoperative hypoxemia development.
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