Respiratory Tract Diseases Clinical Trial
Official title:
Use of Positive Pressure in Morbidly Obese Patients Undergoing Gastroplasty
The aim of this study was to investigate the effects of using positive pressure in the
preoperative, intraoperative and postoperative morbidly obese individuals undergoing
gastroplasty.
It is believed that the application of these devices before, during or after surgery can
help to improve the lungs and reduce pulmonary complications after surgery to reduce the
stomach.
The aim of this study was to investigate the effects of using positive pressure in the
preoperative, intraoperative and postoperative morbidly obese individuals undergoing
Roux-en-Y gastric bypass with regard to: lung volumes and capacities, the prevalence of
atelectasis, duration of surgery and diaphragmatic mobility.
Individuals with BMI between 40 and 55 kg/m2, aged between 25 and 55 years, were submitted
to Roux-en-Y type gastric bypass by laparotomy. Patients showing a normal preoperative
pulmonary function test were included, but those with hemodynamic instability, a hospital
stay longer than three days or the presence of postoperative complications were excluded.
The volunteers were divided into four different groups:
Gpre: subjects treated with positive pressure in the BiPAP mode (Bi-Level Positive Airway
Pressure) for one hour before surgery; Gpos: individuals treated with positive airway
pressure (BiPAP) for one hour after surgery; Gpeep: individuals treated with 10 cm H2O of
PEEP (Positive End Expiratory Pressure) during the surgical procedure.
Gcont: individuals treated with conventional physiotherapy (CP) according to the routine
service of physiotherapy of the hospital, including the techniques of pulmonary
re-expansion, breathing exercises (deep breaths or fractional), the use of incentive
spirometry (Respiron®), bronchial hygiene resources if necessary (Flutter® and cough active
or assisted) and assisted ambulation. It should be noted that the physiotherapist was
blinded to the individual's participation in the groups, and all patients received
conventional physiotherapy, independent of the group in which they were included.
The respiratory evaluation (preoperative and second postoperative days) consisted of
collecting the anthropometric data, a pulmonary function test and a chest radiography
(inspired and expired).
;
Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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