ReviewBMC anesthesiology2015
Perioperative lung protective ventilation in obese patients.
Review in BMC anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Guideline
- Effects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials.Journal of anesthesia · 2022Pooled it
- The effect of two different surgical positions on pulmonary functions ın laparoscopic sleeve gastrectomies: reverse Trendelenburg vs beach chair.Surgical endoscopy · 2025Trial
- Effect of a Care Bundle Combined with Continuous Positive Airway Pressure in the Postanesthesia Care Unit on Rapid Recovery after Pulmonary Tumor Resection.Journal of healthcare engineering · 2021Trial
- Flow-controlled ventilation (FCV) improves regional ventilation in obese patients - a randomized controlled crossover trial.BMC anesthesiology · 2020Trial
- Does Lung Compliance Optimization Through PEEP Manipulations Reduce the Incidence of Postoperative Hypoxemia in Laparoscopic Bariatric Surgery? A Randomized Trial.Obesity surgery · 2019Trial
- Evaluation of the effects of dexmedetomidine infusion on oxygenation and lung mechanics in morbidly obese patients with restrictive lung disease.BMC anesthesiology · 2018Trial
- Efficacy of Goal-Directed Fluid Therapy via Pleth Variability Index During Laparoscopic Roux-en-Y Gastric Bypass Surgery in Morbidly Obese Patients.Obesity surgery · 2018Trial
- [Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position].Brazilian journal of anesthesiology (Elsevier)Trial
- Impact of pediatric obesity on abdominal surgery outcome: a narrative review.Frontiers in pediatrics · 2026Review
- Ventilation in the obese: physiological insights and management.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Article
- Risk factors for anastomotic leakage after low anterior resection for obese patients with rectal cancer.Surgery today · 2024Article
- Anesthesia for Morbidly Obese Patients.Deutsches Arzteblatt international · 2023Review
- Lung ultrasound for evaluating perioperative atelectasis and aeration in the post-anesthesia care unit.Journal of clinical monitoring and computing · 2023Observational
- One-lung ventilation in obese patients undergoing thoracoscopic lobectomy for lung cancer.Thoracic cancer · 2023Article
- Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update.World journal of surgery · 2022Review
- Article
- Article
- Severity and duration of hypoxemia during outpatient endoscopy in obese patients: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The perioperative use and relevance of protective ventilation in surgical patients is being increasingly recognized. Obesity poses particular challenges to adequate mechanical ventilation in addition to surgical constraints, primarily by restricted lung mechanics due to excessive adiposity, frequent respiratory comorbidities (i.e. sleep apnea, asthma), and concerns of postoperative respiratory depression and other pulmonary complications. The number of surgical patients with obesity is increasing, and facing these challenges is common in the operating rooms and critical care units worldwide. In this review we summarize the existing literature which supports the following recommendations for the perioperative ventilation in obese patients: (1) the use of protective ventilation with low tidal volumes (approximately 8 mL/kg, calculated based on predicted -not actual- body weight) to avoid volutrauma; (2) a focus on lung recruitment by utilizing PEEP (8-15 cmH2O) in addition to recruitment maneuvers during the intraoperative period, as well as incentivized deep breathing and noninvasive ventilation early in the postoperative period, to avoid atelectasis, hypoxemia and atelectrauma; and (3) a judicious oxygen use (ideally less than 0.8) to avoid hypoxemia but also possible reabsorption atelectasis. Obesity poses an additional challenge for achieving adequate protective ventilation during one-lung ventilation, but different lung isolation techniques have been adequately performed in obese patients by experienced providers. Postoperative efforts should be directed to avoid hypoventilation, atelectasis and hypoxemia. Further studies are needed to better define optimum protective ventilation strategies and analyze their impact on the perioperative outcomes of surgical patients with obesity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.