Effects of CPAP on gastric pouch pressure after bariatric surgery.

Autor: Weingarten TN; Department of Anesthesiology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. weingarten.toby@mayo.edu, Kendrick ML, Swain JM, Liedl LM, Johnson CP, Schroeder DR, Johnson BD, Sprung J
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2011 Dec; Vol. 21 (12), pp. 1900-5.
DOI: 10.1007/s11695-011-0419-9
Abstrakt: Background: The purpose of this study was to determine if the routine use of postoperative continuous positive airway pressure (CPAP) in patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) is associated with an increase in transmural gastric pouch pressure, which may create the risk for anastomotic leak.
Methods: Transmural gastric pressures (difference between gastric pouch and bladder pressures) were measured postoperatively [post-anesthesia recovery care unit (PACU) arrival (prior to initiation of CPAP), 5 min, 30 min, and PACU discharge] in 28 patients (19 patients used CPAP, 9 patients did not) following laparoscopic RYGB. Changes in pressure over time were assessed using a generalized estimating equation, taking into account the repeated measurements obtained for each subject. In all cases, two-tailed P values ≤0.05 were considered statistically significant.
Results: Among patients that used CPAP, there were no changes in transmural pouch pressure from baseline at any point in time (P = 0.628). However, in patients that did not use CPAP, there was a trend towards increased transmural gastric/pouch pressure (P = 0.053), which could be attributed to a transient decrease in bladder pressure at the 5-min measurement interval.
Conclusions: Application of CPAP did not increase transmural gastric pouch pressure in our bariatric patients; therefore, its use in the post-RYGB patients does not pose a risk for pouch distension, which could lead to the disruption of anastomotic integrity.
Databáze: MEDLINE
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