Total Respiratory System, Lung, and Chest Wall Mechanics in Sedated-Paralyzed Postoperative Morbidly Obese Patients

Pelosi, Paolo; Croci, M.; Ravagnan, I; Vicardi, Pierluigi; Gattinoni, Luciano

doi:10.1378/chest.109.1.144

Cited by 354 publications

(225 citation statements)

References 37 publications

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“…Morbidly obese patients, compared to normal patients, when submitted to abdominal surgery, present with a StaC reduced by a half and AWR increased by almost three times [25]. In our study, although the StaC was lower in dystrophic patients, the difference was not significant; but it is important to remember that the dystrophic group was composed of overweight and underweight patients and not of morbidly obese patients.…”

Section: Discussioncontrasting

confidence: 65%

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Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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Section: Discussioncontrasting

confidence: 65%

“…An increase in weight leads to alterations in mechanical respiration leading to atelectasis [6,25,26]. Morbidly obese patients, compared to normal patients, when submitted to abdominal surgery, present with a StaC reduced by a half and AWR increased by almost three times [25].…”

Section: Discussionmentioning

confidence: 99%

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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“…1 The mechanical derangements of obesity regarding the respiratory system are well established and include a reduced compliance with increased work and oxygen cost of breathing. 2,3 During physical activity, these mechanical abnormalities are associated with increased ventilatory requirements secondary to the increased metabolic load. [4][5][6] A greater work of breathing implies greater activation of the respiratory muscles.…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle endurance training in obese patients

Villiot-Danger

Borel

et al. 2010

Int J Obes

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Objective: Increased respiratory muscle work is associated with dyspnea and poor exercise tolerance in obese patients. We evaluated the effect of respiratory muscle endurance training (RMET) on respiratory muscle capacities, symptoms and exercise capacity in obese patients. Design: A total of 20 obese patients hospitalized for 26 ± 6 days to follow a low-calorie diet and a physical activity program were included in this case-control study. Of them, 10 patients performed RMET (30-min isocapnic hyperpnea at 60-80% maximum voluntary ventilation, 3-4 times per week during the whole hospitalization period: RMET group), while the other 10 patients performed no respiratory training (control (CON) group). RMET and CON groups were matched for body mass index (BMI) (45 ± 7 kg m À2 ) and age (42 ± 12 years). Lung function, respiratory muscle strength and endurance, 6-min walking distance, dyspnea (Medical Research Council scale) and quality of life (short-form health survey 36 questionnaire) were assessed before and after intervention. Results: Similar BMI reduction was observed after hospitalization in the RMET and CON groups (À2±1 kg m À2 , Po0.001). No significant change in lung function and respiratory muscle strength was observed except for vital capacity, which increased in the RMET group ( þ 0.20±0.26 l, P ¼ 0.039). Respiratory muscle endurance increased in the RMET group only ( þ 52±27%, Po0.001). Compared with the CON group, the RMET group had greater improvement in 6MWT ( þ 54 ± 35 versus þ 1 ± 7 m, P ¼ 0.007), dyspnea score (À2±1 versus À1±1 points, P ¼ 0.047) and quality of life (total score: þ 251±132 versus þ 84±152 points, P ¼ 0.018) after hospitalization. A significant correlation between the increase in respiratory muscle endurance and improvement in 6MWT distance was observed (r 2 ¼ 0.36, P ¼ 0.005). Conclusions: The present study indicates that RMET is feasible in obese patients and can induce significant improvement in dyspnea and exercise capacity. RMET may be a promising tool to improve functional capacity and adherence to physical activities in this population, but further studies are needed to confirm these results.

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“…Obesity is known to have an adverse effect on pulmonary function, such as an increase in labored breathing (Sood 2009) and reduction in total respiratory system compliance and lung volumes (Naimark and Cherniack 1960;Pelosi et al 1996;Salome et al 2010). In particular, a reduction in expiratory reserve volume (ERV: the maximum volume of air that can be exhaled from the end-expiratory tidal position) is considered to be closely related to the degree of obesity (Littleton 2012;Brazzale et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Improvement of Pulmonary Function after Comprehensive Obesity Rehabilitation Program in Obese Patients

Takahashi

Ebihara

Kohzuki

2017

Tohoku J. Exp. Med.

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Obesity is a major risk factor of cardiovascular, osteoarthritis, metabolic and pulmonary disorders, and exercise is an efficient method for treating obesity. However, obese patients often complain of dyspnea on exertion, which makes it difficult to continue exercise program. Obesity is also known to have an adverse effect on pulmonary function. The purpose of this study was to examine the effects of a comprehensive obesity rehabilitation (COR) program on pulmonary function in Japanese patients with morbid obesity. We enrolled 29 Japanese obese patients (14 males and 15 females) with BMI > 29 and an average age of 42.2 ± 11.7 years, who underwent the COR program for 1-3 months. Our COR program included a calorierestricted diet, nutritional counseling, exercise training, and health education. We focused on the changes in pulmonary function, anticipating that changes in ventilation volume may contribute to improving exercise tolerance. After the intervention, all the subjects had lost weight, with a mean value of 12.0 kg (P < 0.001). We found that the lung volume compartment was significantly increased after our COR program, and that there is a strong positive correlation between a change in expiratory reserve volume and the weight loss (r = 0.74, P < 0.01). Through the COR program, body fat mass was significantly reduced, while the skeletal muscle mass remained more or less unchanged, which is advantageous for improvement in exercise tolerance. In conclusion, our COR program is helpful to improve the pulmonary function of patients with obesity.

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Total Respiratory System, Lung, and Chest Wall Mechanics in Sedated-Paralyzed Postoperative Morbidly Obese Patients

Cited by 354 publications

References 37 publications

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Respiratory muscle endurance training in obese patients

Improvement of Pulmonary Function after Comprehensive Obesity Rehabilitation Program in Obese Patients

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