Alveolar-arterial gas exchange during muscular work in obesity

Dempsey, Jerome A.; Reddan, W. G.; Rankin, James A.; Balke, Bruno

doi:10.1152/jappl.1966.21.6.1807

Cited by 85 publications

(51 citation statements)

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“…However, arterial PCO 2 responses were blunted compared to predicted, and indicated "a high prevalence of inadequate compensatory hyperventilation (arterial PCO 2 between 35.1 and 38 mmHg; 62) at peak exercise" despite a pronounced plasma lactacidosis (351). These authors concluded that the morbidly obese have insufficient hyperventilation during exercise, although these responses are not evident in all obese individuals (59).…”

Section: Effects Of Obesity On Gas Exchange and Acid-base Balancementioning

confidence: 98%

Effects of Gas Exchange on Acid‐Base Balance

Lindinger

Heigenhauser

2012

Comprehensive Physiology

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This paper describes the interactions between ventilation and acid-base balance under a variety of conditions including rest, exercise, altitude, pregnancy, and various muscle, respiratory, cardiac, and renal pathologies. We introduce the physicochemical approach to assessing acid-base status and demonstrate how this approach can be used to quantify the origins of acid-base disorders using examples from the literature. The relationships between chemoreceptor and metaboreceptor control of ventilation and acid-base balance summarized here for adults, youth, and in various pathological conditions. There is a dynamic interplay between disturbances in acid-base balance, that is, exercise, that affect ventilation as well as imposed or pathological disturbances of ventilation that affect acid-base balance. Interactions between ventilation and acid-base balance are highlighted for moderate- to high-intensity exercise, altitude, induced acidosis and alkalosis, pregnancy, obesity, and some pathological conditions. In many situations, complete acid-base data are lacking, indicating a need for further research aimed at elucidating mechanistic bases for relationships between alterations in acid-base state and the ventilatory responses.

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Section: Effects Of Obesity On Gas Exchange and Acid-base Balancementioning

confidence: 98%

Effects of Gas Exchange on Acid‐Base Balance

Lindinger

Heigenhauser

2012

Comprehensive Physiology

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“…Both oxygen consumption and carbon dioxide production have linear relationship with body weight. Because of the augmented fat mass in the chest and abdominal walls and the upward retraction of this adipose tissue caused by supine position, respiratory difficulty and even oxygen desaturation can be experienced by the obese pregnant woman as these factors further lower the functional residual capacity, expiratory and inspiratory reserve volumes and chest wall compliance leading to worsening of the V/Q relationship [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for Cesarean Delivery in the Morbidly Obese Parturient - Comparison of Commonly used Anesthesia Techniques

Faris¹

2014

ACC

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Background: Obesity in pregnancy can add significantly to obstetric and anesthetic complications. The objective of this study is to identify and compare anesthesia-related complications in different types of elective cesarean anesthetics in morbidly obese parturients. Methods:Retrospective review was done on 205 records of elective cesareans for pregnants with Body Mass Index (BMI) ≥ 40. Data extracted include: type of anesthesia, intraoperative and early postoperative complications, duration of surgery, newborn birth weight, cord blood pH and Apgar scores. Results: The incidence of significant intra-operative hypotension: 65.0%, bradycardia 3.04%, nausea and vomiting 14.21%. Intraoperative hypotension: 67% in spinal and CSE group vs. 34.8% in epidural group (p = 0.0022). Super Morbid Obese (SMO) patients (BMI > 50) had a greater number of attempts at placement for regional techniques compared to Morbidly Obese (MO) patients (BMI 40−49.9) (2.02 vs. 2.61, p = 0.0255). SMO patients had longer mean surgical times (86.6 vs. 107.55 min, p = 0.0001), received more intraoperative crystalloids (1887 vs. 1699 ml, p = 0.0376) and colloids (33.9 vs. 12.6%, p = 0.0007) compared to MO patients. No other complications were significantly different between the 2 compared anesthetic techniques or BMI classes. Conclusion:Spinal anesthesia was the most commonly used technique. It resulted in more hypotension. Parturients with BMI ≥ 50 were more challenging to manage with more regional anesthesia placement attempts, larger fluid volumes and longer surgery times. A well-organized RCT could prove beneficial in validating the most profitable and safe anesthetic technique for bariatric parturients.

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“…O 2 and V . CO 2 are even more pronounced during labor and delivery in obese than in lean parturients [10,12].…”

Section: Respiratory Systemmentioning

confidence: 94%

“…CO 2 ) in proportion to the extent of overweight [10][11][12]. This is caused by the metabolic activity of adipose tissue as well as the increased energy expenditure due to locomotive and respiratory efforts.…”

Section: Respiratory Systemmentioning

confidence: 99%