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Ana Fernandez-Bustamante University of Colorado SOM, USA |
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| TITLE: Pulmonary considerations in obese surgical patients | ||||
| Abstract | ||||
Obesity is a worldwide epidemic and reaches the surgical population. Obese surgical patients pose additional challenges from the pulmonary perspective intra and post-operatively, both during Bariatric and non-Bariatric surgery. Postoperative pulmonary complications are increased in obese patients, and derive from the obesity related pulmonary function impairment, increased risk of diagnosed or undiagnosed sleep apnea and of obesity hypoventilation syndrome. Intra-operative mechanical ventilation presents particular challenges, and recent publications suggest ventilator patterns which may contribute to postoperative pulmonary complications. Furthermore, weaning from mechanical ventilation after surgery in obese patients is a critical period, with a high risk of hypoxemia and hyperventilation. The immediate post-operative use of non-invasive assisted ventilation is controversial, and alternatives for avoiding prolongation of mechanical ventilation or re-intubation are being searched. Suggested intra and post-operative measures to avoid or minimize postoperative pulmonary complications in obese surgical patients, after Bariatric and non-Bariatric surgery, will be further discussed. |
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