Alveolar recruitment manoeuvre results in improved pulmonary function in obese patients undergoing bariatric surgery: a randomised trial

BackgroundBariatric surgery reduces cardiovascular risk in obese patients. Heart failure (HF) is associated with an increased perioperative risk following bariatric surgery. This systematic review aimed to assemble the evidence on bariatric surgery in patients with known HF and the potential effect of bariatric surgery on incident HF in obese patients without prevalent HF.MethodsWe performed a comprehensive literature search up to 30 September 2017 and included studies comparing bariatric surgery to non-surgical treatment in patients with known presurgical HF. To assess whether bariatric surgery has any effect on incident HF, we also assembled studies looking at new-onset HF among patients without HF prior to surgery.ResultsWe found five observational studies (0 randomised trials) comparing bariatric surgery with non-surgical treatment in patients with a diagnosis of HF prior to surgery. A review of the available studies (n=676 patients) suggested reduced admission rates for HF exacerbation and increased left ventricular ejection fraction after bariatric surgery. No meta-analysis was possible due to the heterogeneous nature of these studies. Seven studies (one randomised trial) reported data on new-onset HF in obese patients without HF prior to bariatric surgery (n=111 127 patients). When comparing surgical to non-surgical treatment groups, the pooled univariable and multivariable HRs for incident HF were 0.28 (95% CI 0.13 to 0.55) and 0.44 (95% CI 0.36 to 0.55), respectively.ConclusionIn this systematic review, no randomised trial assessed the benefits and risks of bariatric surgery in obese patients with concomitant HF. Available studies do, however, show that surgery might prevent incident HF.

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Candidates for Bariatric Surgery: Morbidly Obese Patients with Pulmonary Dysfunction

Journal of Obesity ◽

10.1155/2012/878371 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Yu-Feng Wei ◽

Huey-Dong Wu

Keyword(s):

Cardiovascular Disease ◽

Bariatric Surgery ◽

Pulmonary Function ◽

Respiratory Symptoms ◽

Morbidly Obese ◽

Obese Patients ◽

Obstructive Sleep ◽

Long Term Treatment ◽

Impaired Pulmonary Function ◽

The Impact

Obesity is a well-known major risk factor of cardiovascular disease and is associated with various comorbidities. The impact of obesity on pulmonary function remains unclear. Reductions in chest wall compliance and respiratory muscle strength due to a high percent body fat and localized fat distribution contributes to impaired pulmonary function and the occurrence of adverse respiratory symptoms. Dietary modifications and pharmaceutical agents are not effective in the long-term treatment of obesity. Treatment of morbidly obese patients using bariatric surgery has increased each year, especially after the introduction of video laparoscopic techniques. Effective weight loss after bariatric surgery may improve cardiovascular disease risk factors, including diabetes, hypertension, dyslipidemia, atherosclerosis, inflammation, chronic kidney disease, obstructive sleep apnea, and obesity hypoventilation syndrome. Bariatric surgery has also been associated with significantly improved respiratory symptoms and pulmonary function. We currently present a review of principal studies that evaluated the effects of obesity on pulmonary function and the identification of anthropometric factors of obesity that correspond to the reversal of respiratory symptoms and impaired pulmonary function after bariatric surgery.

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The influence of biphasic positive airway pressure vs. sham biphasic positive airway pressure on pulmonary function in morbidly obese patients after bariatric surgery

Anestezjologia Intensywna Terapia ◽

10.5114/ait.2019.85868 ◽

2019 ◽

Vol 51 (2) ◽

pp. 88-95

Author(s):

Aikaterini N. Alexandropoulou ◽

Konstantinos Louis ◽

Alexandros Papakonstantinou ◽

Konstantinos Tzirogiannis ◽

Elissavet Stamataki ◽

...

Keyword(s):

Bariatric Surgery ◽

Pulmonary Function ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Morbidly Obese ◽

Obese Patients ◽

Biphasic Positive Airway Pressure

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Influência das manobras de recrutamento alveolar na melhora da mecânica ventilatória em pacientes obesos submetidos a cirurgia bariátrica / Influence of alveolar recruitment maneuvers in improving ventilatory mechanics in obese patients submitted to bariatric surgery

Brazilian Journal of Health Review ◽

10.34119/bjhrv4n1-109 ◽

2021 ◽

Vol 4 (1) ◽

pp. 1252-1257

Author(s):

Acsa Mendes de Albuquerque ◽

Ada Maria Tavares Alves ◽

Amanda Amorim Viana Sandes ◽

Ana Lívia Almeida de Assis ◽

Domingos Sávio Amorim de Souza Dias Guimarães ◽

...

Keyword(s):

Bariatric Surgery ◽

Alveolar Recruitment ◽

Obese Patients ◽

Recruitment Maneuvers ◽

Ventilatory Mechanics

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Impact of Bariatric Surgery on Pulmonary Function and Nitric Oxide in Asthmatic and Non-Asthmatic Obese Patients

Journal of Asthma ◽

10.3109/02770903.2011.587581 ◽

2011 ◽

Vol 48 (6) ◽

pp. 553-557 ◽

Cited By ~ 16

Author(s):

Carlo Lombardi ◽

Sabrina Gargioni ◽

Angelo Gardinazzi ◽

Giorgio Walter Canonica ◽

Giovanni Passalacqua

Keyword(s):

Nitric Oxide ◽

Bariatric Surgery ◽

Pulmonary Function ◽

Obese Patients

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Effects of Inspiratory Muscle Training on Muscular and Pulmonary Function After Bariatric Surgery in Obese Patients

Obesity Surgery ◽

10.1007/s11695-010-0349-y ◽

2011 ◽

Vol 21 (9) ◽

pp. 1389-1394 ◽

Cited By ~ 23

Author(s):

Carla Cristine Cunha Casali ◽

Ana Paula Manfio Pereira ◽

José Antônio Baddini Martinez ◽

Hugo Celso Dutra de Souza ◽

Ada Clarice Gastaldi

Keyword(s):

Bariatric Surgery ◽

Pulmonary Function ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Obese Patients ◽

Muscle Training

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Using concept maps to describe the evolution in obese patients' knowledge and expectations following bariatric surgery

Education thérapeutique du patient - Therapeutic patient education ◽

10.1051/tpe/2009009 ◽

2009 ◽

Vol 1 (1) ◽

pp. 49-55 ◽

Cited By ~ 7

Author(s):

Claire Marchand ◽

Christine Poitou ◽

Claudie Pinosa ◽

Isabelle Harry ◽

Arnaud Basdevant ◽

...

Keyword(s):

Bariatric Surgery ◽

Concept Maps ◽

Obese Patients

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POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

Medical Connections ◽

10.33311/medcon.2019.49.1.1 ◽

2019 ◽

Vol 49 (1/2019) ◽

Keyword(s):

Insulin Resistance ◽

Bariatric Surgery ◽

Serum Levels ◽

Medical Laboratory ◽

Leptin Resistance ◽

Obese Patients ◽

Laboratory Assessment ◽

Serum Leptin ◽

Before And After ◽

Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

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