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Published in: Obesity Surgery 12/2011

01-12-2011 | Physiology Research

Effects of CPAP on Gastric Pouch Pressure After Bariatric Surgery

Authors: Toby N. Weingarten, Michael L. Kendrick, James M. Swain, Lavonne M. Liedl, Christopher P. Johnson, Darrell R. Schroeder, Bruce D. Johnson, Juraj Sprung

Published in: Obesity Surgery | Issue 12/2011

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Abstract

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.
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Metadata
Title
Effects of CPAP on Gastric Pouch Pressure After Bariatric Surgery
Authors
Toby N. Weingarten
Michael L. Kendrick
James M. Swain
Lavonne M. Liedl
Christopher P. Johnson
Darrell R. Schroeder
Bruce D. Johnson
Juraj Sprung
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 12/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0419-9

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