The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery
Abstract Context: Perioperative management of morbidly obese patients undergoing bariatric surgery is challenging. Lacking standardized perioperative protocols, complication rates may be high. This retrospective study aims to quantify the incidence of significant blood pressure decreases on inductio...
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International Journal of Clinical Anesthesia and Research - Heighten Science Publications Corporation
2018
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ftheightenscienc:oai:heighpubs.org:10.29328/journal.ijcar.1001006 2023-10-01T03:58:21+02:00 The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery Veronica Atterhem Magnus Hultin Tomi Myrberg 2018-07-25 https://www.heighpubs.org/hacr/ijcar-aid1006.php en eng International Journal of Clinical Anesthesia and Research - Heighten Science Publications Corporation https://www.heighpubs.org/hacr/ijcar-aid1006.php Copyright © Veronica Atterhem et al. Research Article 2018 ftheightenscienc 2023-09-01T13:36:25Z Abstract Context: Perioperative management of morbidly obese patients undergoing bariatric surgery is challenging. Lacking standardized perioperative protocols, complication rates may be high. This retrospective study aims to quantify the incidence of significant blood pressure decreases on induction of anesthesia and intraoperative hypoxemia, before implementation of a standardized protocol designed for bariatric surgery. Design: Retrospective, observational study. Setting: A 250-bed county hospital in northern Sweden. Subjects: 219 morbidly obese patients (body mass index > 35 kg/m2) who underwent bariatric surgery between 2003 and 2008. Main outcome measures: Incidence of systolic blood pressure (SAP) falls to less than 70% of the preoperative baseline during induction of anesthesia and incidence of perioperative hypoxemia. Results: The incidence of confirmed SAP falls to below 70% of baseline at induction of anesthesia was 56.2% (n = 123/219). This incidence rose with increasing age (p < 0.001) but not with body mass index (BMI). 3.7% (n = 8/219) of cases were marked as difficult intubations. A transient period of hypoxemia was observed in 6.8% (n = 15/219) and was more common with increasing BMI (p = 0.005). Fourteen different drug combinations were used in the study population. Of those administered an induction anesthetic drug, 72.6% (n = 159/193) were given an overdose when calculated by lean body weight, but this did not correlate significantly to SAP falls (p = 0.468). Conclusion: The incidence of a significant blood pressure fall upon induction of anesthesia was common. The incidence of airway and ventilation problems were low. Overdosing of anesthetics and excessive variation in applied anesthesia methods were found. Article in Journal/Newspaper Northern Sweden Heighten Science Publication Journals |
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description |
Abstract Context: Perioperative management of morbidly obese patients undergoing bariatric surgery is challenging. Lacking standardized perioperative protocols, complication rates may be high. This retrospective study aims to quantify the incidence of significant blood pressure decreases on induction of anesthesia and intraoperative hypoxemia, before implementation of a standardized protocol designed for bariatric surgery. Design: Retrospective, observational study. Setting: A 250-bed county hospital in northern Sweden. Subjects: 219 morbidly obese patients (body mass index > 35 kg/m2) who underwent bariatric surgery between 2003 and 2008. Main outcome measures: Incidence of systolic blood pressure (SAP) falls to less than 70% of the preoperative baseline during induction of anesthesia and incidence of perioperative hypoxemia. Results: The incidence of confirmed SAP falls to below 70% of baseline at induction of anesthesia was 56.2% (n = 123/219). This incidence rose with increasing age (p < 0.001) but not with body mass index (BMI). 3.7% (n = 8/219) of cases were marked as difficult intubations. A transient period of hypoxemia was observed in 6.8% (n = 15/219) and was more common with increasing BMI (p = 0.005). Fourteen different drug combinations were used in the study population. Of those administered an induction anesthetic drug, 72.6% (n = 159/193) were given an overdose when calculated by lean body weight, but this did not correlate significantly to SAP falls (p = 0.468). Conclusion: The incidence of a significant blood pressure fall upon induction of anesthesia was common. The incidence of airway and ventilation problems were low. Overdosing of anesthetics and excessive variation in applied anesthesia methods were found. |
format |
Article in Journal/Newspaper |
author |
Veronica Atterhem Magnus Hultin Tomi Myrberg |
spellingShingle |
Veronica Atterhem Magnus Hultin Tomi Myrberg The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
author_facet |
Veronica Atterhem Magnus Hultin Tomi Myrberg |
author_sort |
Veronica Atterhem |
title |
The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
title_short |
The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
title_full |
The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
title_fullStr |
The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
title_full_unstemmed |
The incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for Bariatric surgery |
title_sort |
incidence of hemodynamic and respiratory adverse events in morbidly obese presenting for bariatric surgery |
publisher |
International Journal of Clinical Anesthesia and Research - Heighten Science Publications Corporation |
publishDate |
2018 |
url |
https://www.heighpubs.org/hacr/ijcar-aid1006.php |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
https://www.heighpubs.org/hacr/ijcar-aid1006.php |
op_rights |
Copyright © Veronica Atterhem et al. |
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1778531025553457152 |