Cavalcanti Mabelle Gomes de Oliveira, Andrade Lívia Barboza, Santos Patrícia Clara Pereira Dos, Lucena Leandro Ricardo Rodrigues
Institute of Integral Medicine Prof. Fernando Figueira, Recife, Brazil.
Arq Bras Cir Dig. 2018 Jun 21;31(1):e1361. doi: 10.1590/0102-672020180001e1361.
Obesity is characterized by excessive accumulation of body fat, which causes damage to the health of individuals, such as breathing difficulties.
To verify the results of non-invasive ventilation as a preventive strategy on the decline of respiratory function and postoperative complications in patients undergoing Roux-en-Y gastric bypass.
This is a randomized trial, according to CONSORT standards, with obese adults aged 18-40 years. Randomized control group (n=25) only received guidelines regarding posture, early ambulation and cough stimuli, and in the NIV group (n=25), in addition to the aforementioned group, non-invasive ventilation was performed with two pressure levels, once day for 60 min, from the 1st to the 3rd postoperative day (POD). Both groups were evaluated in the preoperative period and in the 1st and 3rd POD for respiratory function, which were: slow vital capacity (VC), inspiratory capacity (IC), minute volume (MV), tidal volume maximal inspiratory muscle strength (Pimax) and peak expiratory flow (PEF). The length of hospital stay and the episodes of postoperative complications were recorded.
Of the 50 patients the majority were young adults with degrees of obesity between III and IV. In the intergroup analysis, there was an improvement in the CVL and MV only in the 1st POD in the NIV group, CI in the three moments evaluated in the NIV group and the PFE in the 1st and 3rd PDO also in this group. The most frequent complications were pneumonia, followed by operative wound infection and atelectasis. There was a significant difference between groups, showing a higher occurrence in pneumonia and atelectasis in the control group. The days of hospitalization and intensive care unit were similar.
It was observed a faster recovery until the 3rd POD in the IC and PEF variables in the NIV group; in addition, there were fewer complications in this group.
肥胖的特征是身体脂肪过度堆积，这会对个体健康造成损害，如呼吸困难。
验证无创通气作为一种预防策略对接受Roux-en-Y胃旁路手术患者呼吸功能下降和术后并发症的效果。
这是一项根据CONSORT标准进行的随机试验，纳入年龄在18至40岁的肥胖成年人。随机对照组（n = 25）仅接受关于体位、早期活动和咳嗽刺激的指导，而在无创通气组（n = 25）中，除上述指导外，从术后第1天至第3天，每天进行一次无创通气，采用两个压力水平，每次60分钟。两组在术前以及术后第1天和第3天评估呼吸功能，评估指标包括：慢肺活量（VC）、吸气量（IC）、分钟通气量（MV）、潮气量、最大吸气肌力（Pimax）和呼气峰值流速（PEF）。记录住院时间和术后并发症的发生情况。
50例患者中大多数为年轻成年人，肥胖程度在III级至IV级之间。组间分析显示，无创通气组仅在术后第1天CVL和MV有所改善，在无创通气组评估的三个时间点IC均有改善，该组在术后第1天和第3天PFE也有改善。最常见的并发症是肺炎，其次是手术伤口感染和肺不张。两组之间存在显著差异，显示对照组肺炎和肺不张的发生率更高。住院天数和重症监护病房天数相似。
观察到无创通气组在术后第3天IC和PEF变量恢复更快；此外，该组并发症更少。
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