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中华肥胖与代谢病电子杂志 ›› 2022, Vol. 08 ›› Issue (04) : 283 -286. doi: 10.3877/cma.j.issn.2095-9605.2022.04.011

综述

肺超声在肥胖患者围术期呼吸管理的应用进展
田茵琦1, 彭雪梅1,()   
  1. 1. 510000 广州,暨南大学附属第一医院麻醉科
  • 收稿日期:2022-08-03 出版日期:2022-11-30
  • 通信作者: 彭雪梅

Application progress of lung ultrasound in perioperative respiratory management of obese patients

YinQi Tian1, Xuemei Peng1,()   

  1. 1. Department of Anesthesiology, the First Affiliated Hospital of Jinan University, GuangZhou 510000, China
  • Received:2022-08-03 Published:2022-11-30
  • Corresponding author: Xuemei Peng
引用本文:

田茵琦, 彭雪梅. 肺超声在肥胖患者围术期呼吸管理的应用进展[J]. 中华肥胖与代谢病电子杂志, 2022, 08(04): 283-286.

YinQi Tian, Xuemei Peng. Application progress of lung ultrasound in perioperative respiratory management of obese patients[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(04): 283-286.

肥胖患者术后肺不张发生率为正常体重患者的两倍,其发展可能会损害气体交换,导致低氧血症及其他肺部并发症,因此,围术期快速并及时识别肥胖患者肺不张变得尤为重要,肺超声(LUS)技术已被证实可用于诊断和跟踪一系列肺部病理变化及监测肺通气情况,本综述旨在阐明LUS作为肥胖患者围术期肺不张等监测工具的临床应用进展。

The incidence of postoperative atelectasis in obese patients is twice that in normal weight patients. The development of atelectasis may impair gas exchange and lead to hypoxemia and other pulmonary complications. Therefore, rapid and timely identification of atelectasis in obese patients during perioperative period becomes particularly important. LUS technology has been proven to be used to diagnose and track a series of pulmonary pathological changes and monitor pulmonary ventilation. This review aims to clarify the clinical application progress of pulmonary ultrasound as a monitoring tool for perioperative atelectasis in obese patients.

[1]
Brovman EY, Foley CA, Shen AH, et al. Intraoperative ventilation patterns in morbidly obese patients undergoing laparoscopic bariatric surgery [J]. J Laparoendosc Adv Surg Tech A, 2018, 28(12): 1463-1470.
[2]
Bautista A, Hrushka L, Lenhardt R. Procedural sedation in the morbidly obese: implications, complications, and management [J]. Int Anesthesiol Clin, 2020, 58(3): 41-46.
[3]
Bruins S, Sommerfield D, Powers N, et al. Atelectasis and lung recruitment in pediatric anesthesia: An educational review [J]. Paediatr Anaesth, 2022, 32(2): 321-329.
[4]
Shokoohi H, Raymond A, Fleming K, et al. Assessment of point-of-care ultrasound training for clinical educators in Malawi, Tanzania and Uganda [J]. Ultrasound Med Biol, 2019, 45(6): 1351-1357.
[5]
Monastesse A, Girard F, Massicotte N, et al. Lung ultrasonography for the assessment of perioperative atelectasis: a pilot feasibility study [J]. Anesth Analg, 2017, 124(2): 494-504.
[6]
Tonelotto B, Pereira SM, Tucci MR, et al. Intraoperative pulmonary hyperdistention estimated by transthoracic lung ultrasound: a pilot study [J]. Anaesth Crit Care Pain Med, 2020, 39(6): 825-831.
[7]
Mongodi S, De Luca D, Colombo A, et al. Quantitative lung ultrasound: technical aspects and clinical applications [J]. Anesthesiology, 2021, 134(6): 949-965.
[8]
Lichtenstein DA. Lung ultrasound in the critically ill [J]. Ann Intensive Care, 2014, 4(1): 1.
[9]
Staub LJ, Mazzali Biscaro RR, Kaszubowski E, et al. Lung ultrasound for the emergency diagnosis of pneumonia, acute heart failure, and exacerbations of chronic obstructive pulmonary disease/asthma in adults: a systematic review and meta-analysis [J]. J Emerg Med, 2019, 56(1): 53-69.
[10]
Mongodi S, Bouhemad B, Orlando A, et al. modified lung ultrasound score for assessing and monitoring pulmonary aeration [J]. Ultraschall Med, 2017, 38(5): 530-537.
[11]
Zou T, Yin W, Diddams M, et al. The global and regional lung ultrasound score can accurately evaluate the severity of lung disease in critically ill patients [J]. J Ultrasound Med, 2020, 39(9): 1879-1880.
[12]
Rouby JJ, Arbelot C, Gao Y, et al. Training for Lung Ultrasound Score Measurement in Critically Ill Patients [J]. Am J Respir Crit Care Med, 2018, 198(3): 398-401.
[13]
Zieleskiewicz L, Markarian T, Lopez A, et al. Comparative study of lung ultrasound and chest computed tomography scan in the assessment of severity of confirmed COVID-19 pneumonia [J]. Intensive Care Med, 2020, 46(9): 1707-1713.
[14]
Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity [J]. Nat Med, 2020, 26(4): 485-497.
[15]
Xie C, Sun K, You Y, et al. Feasibility and efficacy of lung ultrasound to investigate pulmonary complications in patients who developed postoperative Hypoxaemia-a prospective study [J]. BMC Anesthesiol, 2020, 20(1): 220.
[16]
Brodsky JB. Recent advances in anesthesia of the obese patient [J]. F1000Res, 2018, 7(1): 1195-1199.
[17]
Gao D, Sun L, Wang N, et al. Impact of 30° reserve trendelenburg position on lung function in morbidly obese patients undergoing laparoscopic sleeve gastrectomy [J]. Front Surg, 2022, 9: 792697.
[18]
Miskovic A, Lumb AB. Postoperative pulmonary complications [J]. Br J Anaesth, 2017, 118(3): 317-334.
[19]
SERIN SO, Işıklar A, Karaören G, et al. Atelectasis in bariatric surgery: review analysis and key practical recommendations [J]. Turk J Anaesthesiol Reanim, 2019, 47(6): 431-438.
[20]
Soldati G, Demi M, Smargiassi A, et al. The role of ultrasound lung artifacts in the diagnosis of respiratory diseases [J]. Expert Rev Respir Med, 2019, 13(2): 163-172.
[21]
Zieleskiewicz L, Papinko M, Lopez A, et al. Lung ultrasound findings in the postanesthesia care unit are associated with outcome after major surgery: a prospective observational study in a high-risk cohort [J]. Anesth Analg, 2021, 132(1): 172-181.
[22]
Adler A C, Siddiqui A, Chandrakantan A, et al. Lung and airway ultrasound in pediatric anesthesia [J]. Paediatr Anaesth, 2022, 32(2): 202-208.
[23]
Armbruster W, Eichholz R, Notheisen T. lung ultrasound for anesthesia, intensive care and emergency medicine [J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2019, 54(2): 108-127.
[24]
Bosch L, Mathe O, Robin JJ, et al. Assessment of lung ultrasound for early detection of respiratory complications in thoracic surgery [J]. Braz J Anesthesiol, 2022, 72(1): 128-134.
[25]
Grassi L, Kacmarek R, Berra L. Ventilatory mechanics in the patient with obesity [J]. Anesthesiology, 2020, 132(5): 1246-1256.
[26]
Young CC, Harris EM, Vacchiano C, et al. Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations [J]. Br J Anaesth, 2019, 123(6): 898-913.
[27]
Ferrando C, Soro M, Unzueta C, et al. Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial [J]. Lancet Respir Med, 2018, 6(3): 193-203.
[28]
Elshazly M, Khair T, Bassem M, et al. The use of intraoperative bedside lung ultrasound in optimizing positive end expiratory pressure in obese patients undergoing laparoscopic bariatric surgeries [J]. Surg Obes Relat Dis, 2021, 17(2): 372-378.
[29]
Simon P, Girrbach F, Petroff D, et al. Individualized versus Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients: A Secondary Analysis [J]. Anesthesiology, 2021, 134(6): 887-900.
[30]
Bluth T, Serpa Neto A, Schultz MJ, et al. Effect of intraoperative high positive end-expiratory pressure (PEEP) with recruitment maneuvers vs low PEEP on postoperative pulmonary complications in obese patients: a randomized clinical trial [J]. Jama, 2019, 321(23): 2292-2305.
[31]
Vaithialingam B, Muthuchellappan R. Feasibility of THRIVE oxygenation and intra-operative lung-protective ventilation in morbidly obese patients undergoing neurosurgical procedures [J]. Saudi J Anaesth, 2022, 16(3): 361-363.
[32]
Nestler C, Simon P, Petroff D, et al. Individualized positive end-expiratory pressure in obese patients during general anaesthesia: a randomized controlled clinical trial using electrical impedance tomography [J]. Br J Anaesth, 2017, 119(6): 1194-1205.
[33]
Yang Y, Geng Y, Zhang D, et al. Effect of lung recruitment maneuvers on reduction of atelectasis determined by lung ultrasound in patients more than 60 years old undergoing laparoscopic surgery for colorectal carcinoma: a prospective study at a single center [J]. Med Sci Monit, 2021, 27: e926748.
[34]
Liu Y, Wang J, Geng Y, et al. The effect of ultrasound-guided lung recruitment maneuvers on atelectasis in lung-healthy patients undergoing laparoscopic gynecologic surgery: a randomized controlled trial [J]. BMC Anesthesiol, 2022, 22(1): 200.
[35]
Yang D, Grant M C, Stone A, et al. A Meta-analysis of intraoperative ventilation strategies to prevent pulmonary complications: is low tidal volume alone sufficient to protect healthy lungs? [J]. Ann Surg, 2016, 263(5): 881-887.
[36]
Wang QY, Ji YW, An LX, et al. Effects of individualized PEEP obtained by two different titration methods on postoperative atelectasis in obese patients: study protocol for a randomized controlled trial [J]. Trials, 2021, 22(1): 704.
[37]
Gama De Abreu M, Schultz MJ, Pelosi P. Atelectasis during general anaesthesia for surgery: should we treat atelectasis or the patient? [J]. Br J Anaesth, 2020, 124(6): 662-664.
[38]
Guerra-Londono CE, Han X, Penning DH. Postoperative pulmonary complications in the morbidly obese: the role of tidal volume and type of abdominal surgery [J]. Respir Care, 2020, 65(12): 1908-1915.
[39]
Brusasco C, Santori G, Bruzzo E, et al. Quantitative lung ultrasonography: a putative new algorithm for automatic detection and quantification of B-lines [J]. Crit Care, 2019, 23(1): 288.
[40]
Torres Macho J, García De Casasola Sánchez G. The lung, paradigm of point-of-care ultrasound [J]. Rev Clin Esp (Barc), 2021, 221(5): 281-282.
[41]
Dransart-Rayé O, Roldi E, Zieleskiewicz L, et al. Lung ultrasound for early diagnosis of postoperative need for ventilatory support: a prospective observational study [J]. Anaesthesia, 2020, 75(2): 202-209.
[42]
[42] Frassanito L, Sonnino C, Pitoni S, et al. Lung ultrasound to monitor the development of pulmonary atelectasis in gynecologic oncologic surgery [J]. Minerva Anestesiol, 2020, 86(12): 1287-1295.
[43]
Mongodi S, Santangelo E, De Luca D, et al. Quantitative lung ultrasound: time for a consensus? [J]. Chest, 2020, 158(2): 469-470.
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