Ventilación y vía aérea en el obeso / Ventilation and airway in obesity

Diciembre 3,  2016. No. 2527

El reclutamiento de volumen pulmonar durante la cirugía no afecta la espirometría postoperatoria ni el riesgo de hipoxemia después de la derivación gástrica laparoscópica en pacientes con obesidad mórbida: un estudio controlado y aleatorizado. Recruitment of lung volume during surgery neither affects the postoperative spirometry nor the risk of hypoxaemia after laparoscopic gastric bypass in morbidly obese patients: a randomized controlled study. Defresne AA1, Hans GA1, Goffin PJ1, Bindelle SP1, Amabili PJ1, DeRoover AM2, Poirrier R3, Brichant JF1, Joris JL4. Br J Anaesth. 2014 Sep;113(3):501-7. doi: 10.1093/bja/aeu101. Epub 2014 May 15. Abstract BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation. Whether these benefits persist after operation remains unknown. We tested the hypothesis that intraoperative RMs associated with PEEP improve postoperative spirometry including FRC and reduce the incidence of postoperative hypoxaemia in morbidly obese (MO) patients undergoing laparoscopic gastric bypass.  CONCLUSIONS: This study demonstrates that when added to a protective mechanical ventilation combining low tidal volume and high PEEP, two RMs do not improve postoperative lung function including FRC, arterial oxygenation, and the incidence of obstructive apnoea in MO patients after laparoscopic upper abdominal surgery. PDF ¿La anestesia realmente causa atelectasia persistente? Does anaesthesia really cause persistent atelectasis? Drummond GB1. Br J Anaesth. 2015 Jul;115(1):131. doi: 10.1093/bja/aev186. PDF Uso del tubo endotraqueal VivaSight™ de lumen único en pacientes con obesidad mórbida sometidos a manga gástrica laparoscópica The use of VivaSight™ single lumen endotracheal tube in morbidly obese patients undergoing laparoscopic sleeve gastrectomy. Barak M1, Assalia A2, Mahajna A2, Bishara B2, Braginski A3, Kluger Y2. BMC Anesthesiol. 2014 May 5;14:31. doi: 10.1186/1471-2253-14-31. eCollection 2014. Abstract BACKGROUND: The population of obese patients is progressively growing and bariatric operations are becoming increasingly common. Morbidly obese patients require special anesthetic care and are often considered to be difficult to ventilate and intubate. The VivaSight™ Single Lumen tube is an endotracheal tube with a camera embedded in its tip. The view from the tip appears continuously on a monitor in the anesthesiologist's vicinity. The aim of this study was to assess the VivaSight™ in comparison with conventional endotracheal tube as an aid in the intubation and surveillance of tube position during surgery of obese patients. CONCLUSION: We found the VivaSight™ SL to be helpful in the endotracheal intubation and continuous surveillance of tube position in morbidly obese patients undergoing laparoscopic sleeve gastrectomy. KEYWORDS: Airway; Anesthetic techniques; Bariatric complications; Equipment; Fiber-optic; Mechanical; Morbid obesity; Surgery; Ventilation PDF Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

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