2014
DOI: 10.1590/s0102-6720201400s100007
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Use of positive pressure in the bariatric surgery and effects on pulmonary function and prevalence of atelectasis: randomized and blinded clinical trial

Abstract: BackgroundIn surgical procedures, obesity is a risk factor for the onset of intra and postoperative respiratory complications.AimDetermine what moment of application of positive pressure brings better benefits on lung function, incidence of atelectasis and diaphragmatic excursion, in the preoperative, intraoperative or immediate postoperative period.MethodRandomized, controlled, blinded study, conducted in a hospital and included subjects with BMI between 40 and 55 kg/m2, 25 and 55 years, underwent bariatric s… Show more

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Cited by 31 publications
(20 citation statements)
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References 35 publications
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“…In this study, the fact that the ERV did not change compared to preoperative values in the PAR-G shortly after extubation and that the 1PO-G had lower values demonstrates the need to reexpand collapsed alveolar units as early as possible. A study by Baltieri et al 16 comparing the use of positive pressure in the preoperative, intraoperative, and immediate postoperative phases demonstrated that it is always beneficial in restoring the ERV; however, when applied in the immediate postoperative, it decreases the prevalence of atelectasis.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In this study, the fact that the ERV did not change compared to preoperative values in the PAR-G shortly after extubation and that the 1PO-G had lower values demonstrates the need to reexpand collapsed alveolar units as early as possible. A study by Baltieri et al 16 comparing the use of positive pressure in the preoperative, intraoperative, and immediate postoperative phases demonstrated that it is always beneficial in restoring the ERV; however, when applied in the immediate postoperative, it decreases the prevalence of atelectasis.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, the present research group has been studying effective ways to restore lung volumes and capacities and prevent atelectasis in the post-operative period following bariatric surgery. A preliminary study by Baltieri et al 16 demonstrated beneficial effects of the application of bilevel positive airway pressure (BiPAP) on the restoration of expiratory reserve volume (ERV) and reduction in atelectasis immediately after extubation, while still in the post-anesthetic recovery (PAR) room. The objective of the present study was to compare the effects of BiPAP application on the immediate postoperative period, while still in the post-anesthetic recovery room, during the first postoperative day, concerning pulmonary function and the prevalence of atelectasis.…”
Section: Pulmonary Function Testmentioning
confidence: 99%
“…Since the 2006 publication of these systematic reviews (Lawrence et al 2006, Pasquina et al 2006, seven additional RCTs have been published (Baltieri et al 2014, Barbalho-Moulim et al 2011, Dronkers 2008, Kulkarni et al 2010, Samnani et al 2014, Zhang et al 2015. The findings of these further studies are summarised in Table 3 and the results and context of the findings are discussed elsewhere in this paper where appropriate.…”
Section: Postoperative Breathing Exercisesmentioning
confidence: 99%
“…The use of non-invasive ventilation (NIV) is currently method capable of offering positive pressure, which is useful in increasing oxygenation, reducing respiratory complications, and increasing the incidence of anastomosis dehiscences 1 . NIV can be offered in the two-level (bilevel) or positive airway (CPAP) mode and is an alternative for the prevention of pulmonary complications, as it decreases muscle fatigue, improves functional residual capacity (FRC), reduces areas of intrapulmonary shunt through the recruitment of collapsed alveolar units, aiming at the adequate maintenance of gas exchange, facilitating alveolar ventilation and reducing dyspnea, reducing respiratory work 1 , 2 .…”
Section: Introductionmentioning
confidence: 99%