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Revista Brasileira de Anestesiologia

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REMISTICO, Paula Patelli Juliani et al. Impact of alveolar recruitment maneuver in the postoperative period of videolaparoscopic bariatric surgery. Rev. Bras. Anestesiol. [online]. 2011, vol.61, n.2, pp.169-176. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: Pulmonary complications in bariatric surgery are common and, therefore, alveolar recruitment maneuvers (ARM) have been used to prevent or reduce them in the postoperative period (POP). The aim of this study was to evaluate the impact of ARM performed intraoperatively in patients undergoing bariatric surgery by videolaparoscopy in the incidence of postoperative pulmonary complications. METHODS: Randomized clinical trial with 30 patients divided into control group (CG) and experimental group (EG), with analysis of spirometric, ventilatory, hemodynamic, and radiographic variables. ARM was performed in EG with positive end expiratory pressure of 30 cmH2O and inspiratory plateau pressure of 45 cmH2O for 2 minutes after pneumoperitoneum deflation. RESULTS: We observed a significant decrease in spirometric values (p < 0.001) and higher incidence of pulmonary complications on chest radiograph (p = 0.02) in CG, as well as significant improvement in dyspnoea Borg scale (p < 0.001) in EG. CONCLUSIONS: We conclude that ARM is a safe and effective technique when used for prevention of pulmonary complications in patients undergoing bariatric surgery, resulting in more favorable radiological and spirometric findings in the experimental group compared to the control group in the PO.

Keywords : Positive Pressure Respiration; Postoperative Complications; Pulmonary Atelectasis; Laparoscopy; Bariatric Surgery.

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