Abstract
Introduction: The positive pressure in the airway can contribute to the restoration of lung volumes and capacities and prevent respiratory complications arising from abdominal surgery. The aim was to investigate the use of Bilevel Positive Airway Pressure (BIPAP) in morbidly obese patients in the pre and postoperative bariatric surgery. Methods: Thirty morbidly obese individuals, aged between 25 and 55 years, admitted for bariatric surgery, underwent pulmonary function test preoperatively and on the day of discharge. After the initial assessment, the volunteers were randomly allocated in three groups. GPRE: received BIPAP treatment before surgery, for an hour, GPAR: BIPAP , immediately after surgery in the post-anesthetic recovery, for an hour and GPOST: BIPAP for one hour postoperatively (PO), on the first postoperative day. Results:There were significant reductions in slow vital capacity (SVC) and inspiratory reserve volume (IRV) in the postoperative in the three groups. The expiratory reserve volume (ERV) remained in GPRE and GPAR, while the tidal volume (TV) remained in the PO in the three groups (no significant diference). Comparing the differences between pre and postoperative, among the groups, it could be seen that the SVC showed the smallest decrease in the GPAR. Conclusions:The positive pressure supplied by BIPAP was effective in preserving the TV of morbidly obese patients in the postoperative bariatric surgery regardless of the time of application. The restoration of ERV occurs with the application of BIPAP immediately before surgery that is, in the post-anesthesia recovery, and the lowest reduction in SVC also happens when positive pressure is applied immediately after extubation.FAPESP 2013/06334-8.
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