miércoles, 7 de diciembre de 2016

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.
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.
¿La anestesia realmente causa atelectasia persistente?
Does anaesthesia really cause persistent atelectasis?
Br J Anaesth. 2015 Jul;115(1):131. doi: 10.1093/bja/aev186.
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.
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
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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Anestesiología y Medicina del Dolor

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