الفهرس | Only 14 pages are availabe for public view |
Abstract ABSTRACT Obesity is one of the most major health problems affecting every system and is associated with many consequences including an increased incidence of coronary artery disease, hypertension, diabetes mellitus, dyslipidemia, obstructive sleep apnea. As a reflection of the rising global incidence of obesity, there has been a corresponding increase in the number of obese patients undergoing surgery in general and bariatric surgery in particular. An increased rate of individuals with obesity among patients undergoing laparoscopic assisted surgery (LAS) is a health care concern due to anesthesia and ventilation difficulties in the obese population. Therefore, understanding of physiology and pathophysiology of lung function is an important issue during long-lasting LAS. As the risk of anesthesia and surgery is greater in morbid obese patients than the normal weight population, anesthesiologists should be more familiar with the clinical management of obese patients for all surgery types, especially for weight reduction procedures. Inverse ratio ventilation is a mode of ventilation designed to improve oxygenation at a given level of inspired oxygen. Conventional ventilation uses the times of inspiration and expiration at a ratio of 1:2, giving a longer time for expiration, as it is generally a passive process. Inverse ratio ventilation reverses this ratio to give a longer inspiratory time (1:1 or 2:1) by using rapid inspiratory flow rates. Prolongation of the inspiratory time allows resetting of the targeted pressure to a lower value that keep similar TV with consequent decrease in Ppeak. In conclusion, this study found out that IRV of volume control mode is superior to conventional ratio VCV in morbidly obese patient undergoing laproscopic sleeve gastrectomy as it increases the lung compliance, Partial pressure of oxygen and mean airway pressure together with a decrease in peak and plateau pressures. |