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Airway Closure during Surgical Pneumoperitoneum in Obese Patients.

Anesthesiology

July 2019

From the Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart (D.L.G., G.M.A., A.R., F.B., F.C., L.P., B.R., A.M.D., L.S., G.C., M.A.) Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS (D.L.G., G.M.A., A.R., F.B., F.C., L.P., B.R., A.M.D., L.S., G.C., M.A.) Department of Obstetrics and Gynecology, Catholic University of The Sacred Heart (B.C., M.D., L.T., V.G., G.S.) Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS (B.C., M.D., L.T., V.G., G.S.) Department of Internal Medicine, Catholic University of The Sacred Heart (F.V.) Respiratory Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS (F.V.), Rome, Italy.

Background: Airway closure causes lack of communication between proximal airways and alveoli, making tidal inflation start only after a critical airway opening pressure is overcome. The authors conducted a matched cohort study to report the existence of this phenomenon among obese patients undergoing general anesthesia.

Methods: Within the procedures of a clinical trial during gynecological surgery, obese patients underwent respiratory/lung mechanics and lung volume assessment both before and after pneumoperitoneum, in the supine and Trendelenburg positions, respectively.

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