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Obesity Surgery
Published in: Obesity Surgery 6/2015

01-06-2015 | Original Contributions

Preoperative Inspiratory Muscular Training to Prevent Postoperative Hypoxemia in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery. A Randomized Clinical Trial

Authors: Julio Lloréns, Lucas Rovira, Mayte Ballester, Joaquín Moreno, Javier Hernández-Laforet, Francisco-José Santonja, Norberto Cassinello, Joaquín Ortega

Published in: Obesity Surgery | Issue 6/2015

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Abstract

Background

Morbidly obese patients show an increased risk of postoperative hypoxemia and pulmonary complications when compared with normal weight subjects. The purpose of this study was to determine the effects of preoperative inspiratory muscular training (IMT) on postoperative arterial oxygenation in morbidly obese patients submitted to laparoscopic bariatric surgery.

Methods

Forty-four morbidly obese patients were randomly assigned to receive either preoperative usual care (control group, n = 21) or preoperative IMT (trained group, n = 23) for a month prior to the date of surgery. Data on oxygenation (PaO2/FiO2 ratio) were obtained at 1 h and at 12 h after surgery (PACU 1 h and PACU 12 h, respectively). Data on maximum static inspiratory pressure (MIP) were obtained before and after the training period, and at postanesthesia care unit (PACU) 12-h time point.

Results

PaO2/FiO2 was significantly higher in the trained group than in the control group, both at PACU 1 h (305.2 ± 77.6 vs. 248.8 ± 53.8, P = 0.008) and at PACU 12 h (333.5 ± 59.6 vs. 289.7 ± 79.6, P = 0.044). As a consequence, the percentage of patients with relative hypoxemia (PaO2/FiO2 lower than 300 mmHg) at the time of PACU discharge was higher in the control group (57 vs. 17 %, P: 0.006). MIP was significantly higher in the trained group compared with the control group at the preoperative time point (89.87 ± 19.00 vs. 77.00 ± 21.20 cm H2O, P = 0.04).

Conclusions

Preoperative IMT improved postoperative oxygenation and increased inspiratory muscular strength in morbidly obese patients submitted to laparoscopic bariatric surgery.
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Metadata
Title
Preoperative Inspiratory Muscular Training to Prevent Postoperative Hypoxemia in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery. A Randomized Clinical Trial
Authors
Julio Lloréns
Lucas Rovira
Mayte Ballester
Joaquín Moreno
Javier Hernández-Laforet
Francisco-José Santonja
Norberto Cassinello
Joaquín Ortega
Publication date
01-06-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1487-4

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