Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients

Abstract

Purpose: To compare the prophylactic effects of postoperative continuous positive airway pressure (CPAP) therapy plus conventional postoperatively pulmonary physiotherapy (CPP) and postoperative CPP alone on the development of pulmonary atelectasis after laparoscopic Roux-en-Y gastric bypass (LGBP) in obese patients. Materials and Methods: Patients with BMIs＞27.5 kg/m 2 aged between 20 and 65 years were enrolled in the present study. All subjects received LGBP and were divided into 2 groups. Patients in the CPAP group received both CPAP and CPP therapy postoperatively, and patients in the conventional group received CPP alone. The primary outcome was the incidence of postoperative pulmonary atelectasis as determined by chest X-ray after LGBP, and the secondary outcome was duration of postoperative hospital stay (HS). Results: Seventy-three patients were enrolled in this study. Fifty-seven patients received CPAP plus CPP, and 16 patients received CPP. The CPAP group had an atelectasis incidence of 40.4% (23/57) and the conventional group an incidence of 62.5% (10/16). Multivariate analysis showed the incidence of atelectasis after LGBP was significantly lower in the CPAP group (OR 0.198, 95% CI 0.045-0.874; P=0.033) and that HS was significantly correlated with the developments of atelectasis, pneumonia, and complications (partial correlation coefficients 0.271, 0.444 and 0.382; P-values 0.025, ＜0.05 and ＜0.05, respectively). Conclusion: Patients that received continuous positive airway pressure therapy plus conventional pulmonary physiotherapy postoperatively were at significantly less risk of developing pulmonary atelectasis after LGBP than patients that received conventional pulmonary physiotherapy postoperatively.

Causes and Treatment of Hypoxia During Total Hip Arthroplasty in Elderly Patients: Case Report

“…CPAP appeared to have facilitated ventilation and gas exchange, presumably by re-expanding the collapsed alveoli. (11) One limitation of this case report is that we cannot definitely confirm that hypoxia was caused by atelectasis, as imaging studies, such as chest X-ray or lung CT, cannot be performed during surgery after a sudden onset of hypoxia. Furthermore, the second patient did not show any abnormal find ings after surgery, other than mild atelectasis in the right lower lobe, compared with the patient's preoperative condition.…”

Causes and Treatment of Hypoxia during Total Hip Arthroplasty in Elderly Patients: A Case Report

“…The second patient showed a further improvement in hypoxia with continuous positive airway pressure (CPAP) along with conversion to spontaneous respiration. CPAP appears to have facilitated ventilation and gas exchange, presumably by re-expanding the collapsed alveoli [ 12 ].…”