Respiratory disorders in patients hospitalized for bariatric surgery

Abstract

Background: Obesity can lead to significant respiratory disturbances that may require respiratory therapy.

Aims: To evaluate the need for respiratory therapy in morbid obese patients hospitalized for bariatric surgery.

Methods: 34 patients hospitalized for bariatric surgery (mean age 47.6 years, mean BMI=47.6 kg/m2 ±7.1, 15 female, 19 male) were included. We performed a clinical examination, sleep polygraphy, lung function tests and arterial blood gases (ABG) test.

Results: 16 patients (47,1%) had severe obstructive sleep apnea syndrome (OSA), 3 (8,8%) had moderate OSA. The lung function tests results showed reduced reserve expiratory volume and functional residual capacity in most patients. Vital capacity (VC) was reduced in 10 patients (29%). 3 patients (8.8%) on the first day of the postoperative period developed severe hypoxemia and decompensated respiratory acidosis. This patients were characterized by lower VC (59.3%±14.7 of the proper, p<0.05), severe OSA (apnea-hypopnea index 100.3±18.2, p<0.05), lower mean and minimal nocturnal blood oxygen saturation. CPAP therapy during sleep was used in 56% patients in the pre - and postoperative period. Patients with postoperative hypoventilation required bilevel non-invasive ventilation (NIV) from 1 to 3 days. After normalization of the ABG, CPAP therapy was resumed.

Conclusions: Most of the patients hospitalized for bariatric surgery required respiratory therapy. Severe OSA and reduced VC determined the risk of significant hypoventilation in the postoperative period, which required the use of NIV. Sleep polygraphy, lung function tests and ABG tests allows you to determine the tactics of pre- and postoperative respiratory therapy.