Abstract
Objective: The relationship between obesity and postoperative oxygenation after coronary artery bypass grafting was studied.Methods: Subjects were 68 patients undergoing solitary coronary artery bypass grafting —49 men and 19 women with a mean age of 64 years — divided into 3 groups by body mass index: group L with a body mass index of < 20 kg/m2 (n = 10), group M with a 20 ≦ body mass index < 25 (n = 46), and group H with a 25 ≦ body mass index (n = 12). Perioperative oxygenation was evaluated using respiratory indices measured preoperatively and 3 and 15 hours postoperatively.Results: Postoperative respiratory indices significantly increased from 0.23 to 0.67 (p < 0.001) at 3 hours and to 0.97 (p < 0.01) at 15 hours postoperatively in group L, from 0.27 to 0.80 (p < 0.001) and to 0.94 in group M, and from 0.31 to 1.39 (p < 0.001) and to 1.45 in group H. The postoperative respiratory index in group H was significantly higher (p < 0.01) than that in groups M and L both at 3 and 15 hours postoperatively. Multivariate analysis showed that the coefficients of determination of body mass index to postoperative respiratory index, 23% at 3 hours and 16% at 15 hours postoperatively, were the highest among perioperative factors.Conclusions: Obesity is a major factor impairing postoperative oxygenation. Careful management in a semirecumbent position and/or nasal intermittent positive pressure ventilation may thus be required in obese patients.
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Yamagishi, T., Ishikawa, S., Ohtaki, A. et al. Obesity and postoperative oxygenation after coronary artery bypass grafting. Jpn J Thorac Caridovasc Surg 48, 632–636 (2000). https://doi.org/10.1007/BF03218218
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DOI: https://doi.org/10.1007/BF03218218