0
Articles |

Effect of Bi-Level Positive Airway Pressure (BiPAP) Nasal Ventilation on the Postoperative Pulmonary Restrictive Syndrome in Obese Patients Undergoing Gastroplasty FREE TO VIEW

Jean L. Joris; Thierry M. Sottiaux; Jean Daniel Chiche; Claude J. Desaive; Maurice L. Lamy
Author and Funding Information

Affiliations: From the Departments of Anesthesia and Intensive Care Medicine, University Hospital of Liège, Belgium,  From the Department of Anesthesia and Intensive Care Medicine, Gosselies Hospital, Belgium,  From the Department of Gastrointestinal Surgery, University Hospital of Liège, Belgium

Affiliations: From the Departments of Anesthesia and Intensive Care Medicine, University Hospital of Liège, Belgium,  From the Department of Anesthesia and Intensive Care Medicine, Gosselies Hospital, Belgium,  From the Department of Gastrointestinal Surgery, University Hospital of Liège, Belgium

Affiliations: From the Departments of Anesthesia and Intensive Care Medicine, University Hospital of Liège, Belgium,  From the Department of Anesthesia and Intensive Care Medicine, Gosselies Hospital, Belgium,  From the Department of Gastrointestinal Surgery, University Hospital of Liège, Belgium


1997 by the American College of Chest Physicians


Chest. 1997;111(3):665-670. doi:10.1378/chest.111.3.665
Text Size: A A A
Published online

Abstract

Study objective: Upper abdominal surgery results in a postoperative restrictive pulmonary syndrome. Bi-level positive airway pressure (BiPAP System; Respironics Inc; Murrysville, Pa), which combines pressure support ventilation and positive end-expiratory pressure via a nasal mask, could allow alveolar recruitment during inspiration and prevent expiratory alveolar collapse, and therefore limit the postoperative pulmonary restrictive syndrome. This study investigated the effect of BiPAP on postoperative pulmonary function in obese patients after gastroplasty.

Design: Prospective controlled randomized study.

Setting: GI surgical ward in a university hospital.

Patients: Thirty-three morbidly obese patients scheduled for gastroplasty were studied.

Intervention: The patients were assigned to one of three techniques of ventilatory support during the first 24 h postoperatively: O2 via a face mask, BiPAP System 8/4, with inspiratory and expiratory positive airway pressure set at 8 and 4 cm H2O, respectively, or BiPAP System 12/4 set at 12 and 4 cm H2O. Pulmonary function (FVC, FEV1, and peak expiratory flow rate [PEFR]) were measured the day before surgery, 24 h after surgery, and on days 2 and 3. Oxygen saturation by pulse oximeter (SpO2) was also recorded during room air breathing.

Results: Three patients were excluded. After surgery, FVC, FEV1 PEFR, and SpO2 significantly decreased in the three groups. On day 1, FVC and FEV1 were significantly improved in the group BiPAP System 12/4, as compared with no BiPAP; SpO2 was also significantly improved. After removal of BiPAP System 12/4, these benefits were maintained, allowing faster recovery of pulmonary function. No significant effects were observed on PEFR. BiPAP System 8/4 had no significant effect on the postoperative pulmonary restrictive syndrome.

Conclusion: Prophylactic use of BiPAP System 12/4 during the first 24 h postoperatively significantly reduces pulmonary dysfunction after gastroplasty in obese patients and accelerates reestablishment of preoperative pulmonary function.


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543