Do Changes in Perioperative and Postoperative Treatment Protocol Influence the Frequency of Pulmonary Complications? A Retrospective Analysis of Four Different Bariatric Groups

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Javanainen , M H , Scheinin , T , Mustonen , H & Leivonen , M 2017 , ' Do Changes in Perioperative and Postoperative Treatment Protocol Influence the Frequency of Pulmonary Complications? A Retrospective Analysis of Four Different Bariatric Groups ' , Obesity Surgery , vol. 27 , no. 1 , pp. 64-69 . https://doi.org/10.1007/s11695-016-2236-7

Title: Do Changes in Perioperative and Postoperative Treatment Protocol Influence the Frequency of Pulmonary Complications? A Retrospective Analysis of Four Different Bariatric Groups
Author: Javanainen, Mervi Hannele; Scheinin, Tom; Mustonen, Harri; Leivonen, Marja
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, II kirurgian klinikka
Date: 2017-01
Language: eng
Number of pages: 6
Belongs to series: Obesity Surgery
ISSN: 0960-8923
URI: http://hdl.handle.net/10138/237257
Abstract: The current understanding of prophylaxis of pulmonary complications in bariatric surgery is weak. Purpose: The aim of this study was to observe how changes in perioperative and postoperative treatments affect the incidence of pulmonary complications in bariatric patients. Materials: This is a retrospective clinical study of 400 consecutive bariatric patients. The patients, who either underwent a sleeve gastrectomy or a Roux-en-Y gastric bypass, were divided consecutively into four subgroups with different approaches to perioperative treatment. Methods: The first group (patients 0-100) was recovered in the intensive care unit with minimal mobilization (ICU). They had a urinary catheter and a drain. The second group (patients 101-200) was similar to the first group, but the patients used a continuous positive airway pressure (CPAP) device intermittently (ICU-CPAP). The third group (patients 201-300) was recovered on a normal ward without a urinary catheter or a drain and used a CPAP device (ward-slow). The fourth group (patients 301-400) walked to the operating theater and was mobilized in the recovery room during the first 2 h after the operation (ward-fast). CPAP was also used. Primary endpoints were pulmonary complications, pneumonia, and infection, non-ultra descriptus (NUD). Results: The number of pulmonary complications among the groups was significantly different. A long operation time increased the risk for infection (p <0.001 95 % CI from 2.02 to 6.59 %). Conclusions: Operation time increases the risk for pulmonary complications. Changes in perioperative care toward the ERAS protocol may have a positive effect on the number of pulmonary complications.
Subject: Bariatric surgery
Pulmonary complications
ERAS
Y GASTRIC BYPASS
OBSTRUCTIVE SLEEP-APNEA
SURGERY OUTCOMES
METAANALYSIS
MANAGEMENT
PREDICTORS
DRAINAGE
OBESITY
ASTHMA
TRIAL
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
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