The frequency of respiratory failure in patients with morbid obesity undergoing gastric bypass.

Morbid obesity is associated with multiple metabolic and mechanical abnormalities that increase morbidity and mortality after major abdominal surgery. It is unclear whether patients undergoing bariatric surgery have increased pulmonary complications postoperatively. We performed a retrospective chart review of 207 patients who underwent elective gastric bypass surgery during a recent 2-year period. Body mass index (BMI = kg/m2) of more than 35 was used to define morbid obesity. The purpose of this study was to determine the frequency of respiratory failure, defined as intubation for 24 hours or more and/or reintubation, in these patients. We also evaluated differences in the frequency of respiratory failure between patients with a BMI of 43 or less and those with a BMI of more than 43. Patients with morbid obesity undergoing elective weight loss surgery had few respiratory or other perioperative complications with our experienced team. The rates of respiratory failure and total postoperative complications were 8% in the group with a BMI of 43 or less and 14% in the group with a BMI of more than 43. Skillful anesthetic care allows patients with significant comorbid conditions to benefit from bariatric surgery with reasonable risk in terms of postoperative complications.