Correction Parameters of Respiratory Support in Endoscopic Resection of the Stomach in Patients with the Morbid Obesity
Nevmark, M.I.; Kiselev, R.V.; Shmelev, V.V.
Anesteziologiia i Reanimatologiia 62(1): 46-50
2017
ISSN/ISBN: 0201-7563 PMID: 29932581 Document Number: 692057
In recent years, steadily increasing the number of operations for morbid obesity. One of the most frequently performed worldwide operations at this pathology is the sleeve gastrectomy are approximately 28% of all bariatric surgeries per year It must be stressed that obesity is accompanied by hard changes andfunctional disorders of all body systems, including the respiratory and cardiovascular The aim: to study the effect of respiratory support options combined with high thoracic epidural analgesia, as a component of anesthetic management on central hemodynamics during anesthesia providing endoscopic gastroplasty in patients with morbid obesity. a randomized study of 37 patients with morbid obesity who underwent endoscopic sleeve gastroplasty under anesthesia combined with high thoracic epidural analgesia. Depending on the choice of tactics respiratory support patients were divided into two groups; In group 1 (n-17), the traditional mode of ventilation in group 2 (n-20) modified the ventilation mode. Intraoperative central hemodynamic parameters, external respiration were monitored; acid-base balance is achieved partly by recycling carbon dioxide in a closed breathing circuit using NICO 7300 system (Novametrix Medical Systems Inc. USA), based on the Fick principle. the use of ventilation mode with inversion of the respiratory cycle, high-level application of PEEP titration in stages so you can optimize the parameters of external respiration, gas exchange without adverse effects on the central hemodynamics. The continued elevated levels PaCO₂, PvCO₂, when applying carboxiperitoneum, did not cause gross changes in acid-base balance.