The Effects of BMI on Respiratory and Hemodynamic Parameters in Laparoscopic Bariatric Surgery: An Observational Study

Ayyildiz A., PAMUK A. E., ÜZÜMCÜGİL F., AKÇA B., Yilbas A. A., Sahin T., ...More

Bariatric Surgical Practice and Patient Care, vol.14, no.1, pp.34-40, 2019 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 14 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1089/bari.2018.0043
  • Journal Name: Bariatric Surgical Practice and Patient Care
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
  • Page Numbers: pp.34-40
  • Keywords: Bariatric surgery, body mass index, hemodynamics, morbidly obese, respiratory mechanics
  • Lokman Hekim University Affiliated: Yes


Background: Previous reports addressing morbidly obese patients grouped body mass indexes (BMIs) within wide ranges, such as >40 or 40-60 kg/m2. We aimed to investigate whether the effects of pneumoperitoneum differ in narrow ranged subgroups of BMI in morbidly obese patients. Materials and Methods: Eighteen to 65 year-old, ASA I-II 75 patients were included. The subgroups of BMI were 40 ≤ x < 45, 45 ≤ x < 50, and ≥50 kg/m2. Plato pressure (Pp), peak inspiratory pressure, and etCO2 were recorded beside vital parameters. Dynamic compliances (Cdyn = Vt/PIP-PEEP) were calculated. Arterial blood gases were obtained before pneumoperitoneum (t1), at the end of pneumoperitoneum before desufflation (t2), and after desufflation (t3). Results: Pneumoperitoneum caused similar alterations in hemodynamic parameters and respiratory mechanics in Group I (n = 24), II (n = 28) and III (n = 23). Pp at t1 and t2 was significantly higher in Group II and III (p < 0.017). Cdyn were significantly lower at t1 and t2 in Group III (p < 0.01). The number of patients who required adjustments during pneumoperitoneum was significantly higher in Group III (p < 0.01). Conclusion: The Cdyn and airway pressures in laparoscopic bariatric surgery revealed statistically significant difference between BMI ≥50 kg/m2 and BMI of 40 ≤ x < 45 kg/m2. We suggest that BMIs of 40 ≤ x < 45 and ≥50 kg/m2 should not be described in one group, but grouped separately in future studies addressing respiratory mechanics.