The impact of intraabdominal pressure on the gas-exchange and mechanics of respiration in patients, suffering morbid obesity, while conduction of artificial pulmonary ventilation

Keywords: morbid obesity; artificial pulmonary ventilation, intraabdominal pressure; pressure of abdominal perfusion; hypoxemia

Abstract

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.

Author Biographies

A. P. Mazur, Shalimov National Institute of Surgery and Transplantology, Kyiv

Mazur Andrii Petrovich, medicine doctor,
chief of department of anesthesiology and intensive care.
Shalimov National Institute of Surgery and Transplantation
Kyiv, Heroiv Sevastopolia, 30,
044-408-18-00
mazur1ukr.net
ORCID: http://orcid.org/0000-0002-6873-7573

O. V. Vynnychenko , Shalimov National Institute of Surgery and Transplantology, Kyiv

Vynnychenko Olha Volodymyrivna, doctor
Department of anesthesiology and intensive care,
e-mail: winniola328@gmail.com
Shalimov National Institute of Surgery and Transplantation
Kyiv, Heroiv Sevastopolia, 30,
044-408-18-00
ORCID: http://orcid.org/0000-0003-4338-8730

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Published
2019-08-29
How to Cite
Mazur, A. P., & Vynnychenko , O. V. (2019). The impact of intraabdominal pressure on the gas-exchange and mechanics of respiration in patients, suffering morbid obesity, while conduction of artificial pulmonary ventilation. Klinicheskaia Khirurgiia, 86(8), 31-34. https://doi.org/10.26779/2522-1396.2019.08.31
Section
General Problems of Surgery