Obesity surgery
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Randomized Controlled Trial
Short-term respiratory physical therapy treatment in the PACU and influence on postoperative lung function in obese adults.
Even several days after surgery, obese patients exhibit a measureable amount of atelectasis and thus are predisposed to postoperative pulmonary complications. Particularly in ambulatory surgery, rapid recovery of pulmonary function is desired to ensure early discharge of the obese patient. In this study, we wanted to evaluate intensive short-term respiratory physical therapy treatment (incentive spirometry) in the postanesthesia care unit (PACU) and its impact on pulmonary function in the obese. ⋯ Short-term respiratory physiotherapy during the PACU stay promotes more rapid recovery of postoperative lung function in the obese during the first 24 h.
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Central venous catheterization may be difficult in morbidly obese patients because anatomic landmarks are often obscured. ⋯ The use of ultrasound guidance may increase the success rate and decrease the incidence of complications associated with central venous cannulation. The advantages of this approach is visualization of the anatomical structures at puncture site prior to skin puncture and the ability to track needle and guide-wire placement during the procedure. With its high accuracy in detecting catheter misplacement, bedside ultrasonic examination combined with intraatrial electrocardiogram may further decrease morbidity associated with misplaced central venous catheters.