Serin Sibel Ocak, Işıklar Aysun, Karaören Gülşah, El-Khatib Mohamed Fawzy, Caldeira Vania, Esquinas Antonio
Department of Internal Medicine, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Department of Internal Medicine, Martyr Professor İlhan Varank Sancaktepe Training and Research Hospital, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2019 Dec;47(6):431-438. doi: 10.5152/TJAR.2019.66564. Epub 2019 Sep 2.
Obesity is a condition that affects multiple organ systems, particularly the cardiovascular and respiratory system. In recent years, bariatric surgery has been reported to be the gold standard in the treatment of morbid obesity. Body mass index alone is insufficient to predict risks related to anaesthesia and surgery. Obesity contributes to significant postoperative atelectasis and is considered an independent risk factor for postoperative atelectasis owing to decreased functional residual capacity. The treatment and reversibility of atelectasis developed in obese patients undergoing bariatric surgery are challenging. Therefore, an optimisation of pulmonary functions before surgery, lung-sparing ventilation during the perioperative period, awareness of potential postoperative complications and knowledge about preventive measures and therapeutic approaches have become increasingly important in bariatric surgery. The aim of this review was to aid clinicians in the management of atelectasis in patients undergoing bariatric surgery during the perioperative and postoperative period.
肥胖是一种影响多个器官系统的病症，尤其是心血管和呼吸系统。近年来，有报道称减重手术是治疗病态肥胖的金标准。仅身体质量指数不足以预测与麻醉和手术相关的风险。肥胖会导致显著的术后肺不张，并且由于功能残气量减少，被认为是术后肺不张的独立危险因素。在接受减重手术的肥胖患者中发生的肺不张的治疗和可逆性具有挑战性。因此，术前优化肺功能、围手术期肺保护性通气、对潜在术后并发症的认识以及关于预防措施和治疗方法的知识在减重手术中变得越来越重要。本综述的目的是帮助临床医生在围手术期和术后管理接受减重手术患者的肺不张。
