الفهرس 
OBESITYOnly 14 pages are availabe for public view
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Abstract
M
anaging ventilation and oxygenation during laparoscopic bariatric procedures in morbidly obese patients represents many challenges.
There is no specific guideline on the ventilation modes for this group of patients. Although several studies have been performed to determine the optimal ventilatory settings for those patients, the answer is yet to be found. Volume controlled ventilation can deliver adequate tidal volume but at the cost of increased air way pressure. Pressure controlled ventilation deliver a tidal volume that depends on pressure limit, compliance and resistance. This might reduce the risk of barotrauma. The aim of this study is to compare the effect of these modes of ventilation on respiratory parameters in obese patients undergoing laparoscopic bariatric surgeries and whether this influences the need of postoperative ventilation or not.
The present study was conducted on 40 morbidly obese adult patients of ASA physical status I-II, of both sexes, ranging from 25-45 years old, with body mass index (BMI) 35-45 kg/m2 and scheduled for laparoscopic bariatric surgeries.
General anesthesia with endotracheal intubation and controlled ventilation was conducted in all patients. Patients were divided randomly into two equal groups: group A; received volume controlled ventilation and group B; received pressure controlled ventilation.
The study found no significant difference between the two groups as regards PaO2 and PaO2:FiO2 preoperatively, after pneumoperitonium, at the end of surgery and postoperatively.
The study found that there is a significant difference between the two groups regarding PaCo2. After pneumoperitonium, at the end of surgery and postoperatively PaCo2 levels were lower in group B that received pressure controlled ventilation than in group A that received volume controlled ventilation despite no significant difference between the two groups preoperatively.
The study also showed better dynamic compliance after intubation, after pneumoperitonium and at the end of surgey in group B that received pressure controlled ventilation than in group A that received volume controlled ventilation.
The study also showed no significant difference between the two groups as regards the need of postoperative ventilation.