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Compensatory Exercise Hyperventilation is Restored in the Morbidly Obese After Bariatric Surgery

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Abstract

Background

Morbidly obese individuals may have poor compensatory hyperventilation during exercise. The objective was to examine pulmonary gas exchange and the compensatory hyperventilatory response during exercise pre- and post-weight reduction surgery in obese subjects.

Methods

Fifteen patients (age = 39 ± 8 years, body mass index = 47 ± 6 kg/m2), with an excess weight of 69 ± 17 kg, were recruited. Pulmonary function at rest was assessed and arterial-blood gases were sampled at rest and all levels of exercise pre- and 10 ± 3 weeks postsurgery.

Results

There was a loss of excess weight 21 ± 6 kg (p < 0.01). Waist and hip circumference decreased by 13 ± 9 and 8 ± 7 cm, respectively (p < 0.01). Prior to surgery, there was no compensatory hyperventilation between rest and peak exercise as arterial PCO2 (PaCO2) remained unchanged (37± 3 mm Hg). However, postsurgery, there was compensatory hyperventilation as PaCO2 decreased to 33 ± 2 mm Hg at peak exercise (p < 0.01), with no change in peak oxygen consumption (VO2peak in L/min). Multiple linear regression revealed that the restored ventilatory response to exercise was most strongly associated with the reduction in overall fat mass (adjusted r 2 = 0.25; p = 0.03). Total weight loss of 21 kg induces adequate compensatory hyperventilation that begins to show at about 50% of VO2peak, resulting in improved gas exchange at moderate to peak exercise intensities.

Conclusion

Improvement in compensatory hyperventilation is most closely related to loss in overall fat mass.

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Acknowledgments

The authors would like to thank the Canadian Anesthesiologist’s Society for partially funding this project. The authors would also like to thank the volunteers for being a part of this research study and the anesthesiologists from the Department of Anesthesia at the Montreal General Hospital who inserted the arterial lines in the subjects. We also acknowledge L.C. Lands, M.D., Ph.D., for critically reviewing this manuscript; Nancy E. Mayo, Ph.D., for providing statistical advice; and Jean-Loup Sylvestre, MSc, for help with recruitment of the subjects.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Women’s Health, School of Medicine, Saint Mary’s Health Center, Saint Louis University, 6420 Clayton Road, Room 290, Saint Louis, MO, 63117, USA

    Gerald S. Zavorsky & Do Jun Kim

  2. Department of Pharmacological and Physiological Science, School of Medicine, Saint Louis University, 402 South Grand Blvd., Saint Louis, MO, 63104, USA

    Gerald S. Zavorsky

  3. Department of Surgery, Bariatric Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave. West., Rm S9.030, Montreal, Quebec, H3A-1A1, Canada

    Nicolas V. Christou

Authors
  1. Gerald S. Zavorsky
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  2. Do Jun Kim
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  3. Nicolas V. Christou
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Corresponding author

Correspondence to Gerald S. Zavorsky.

Additional information

G.S. Zavorsky is the recipient of the 2005 Baxter Corporation Award in Anesthesia from the Canadian Anesthesiologist’s Society. G.S. Zavorsky is also Research Scholar–Junior 1 from the Quebec Health Research Foundation (Fonds de la Recherche en Santé du Québec). N.V. Christou is a consultant for Ethicon Endo-Surgery and has stock ownership in Weight Loss Surgery.

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Zavorsky, G.S., Kim, D.J. & Christou, N.V. Compensatory Exercise Hyperventilation is Restored in the Morbidly Obese After Bariatric Surgery. OBES SURG 18, 549–559 (2008). https://doi.org/10.1007/s11695-008-9437-7

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  • DOI: https://doi.org/10.1007/s11695-008-9437-7

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