Impacto de la maniobra de inspiración profunda en el intercambio gaseoso del sujeto con obesidad severa e hipertensión arterial pulmonar asociada a síndrome de Eisenmenger

Santos-Martínez, Luis-Efren; Martínez-Guerra, María-Luisa; Bautista, Edgar; Castillo, Francisco; Castañón, Alicia; Pulido, Tomás; Hernández, José-Luis; Sandoval, Julio
July 2008
Archivos de Cardiología de México;jul-sep2008, Vol. 78 Issue 3, p265
Academic Journal
Obesity and Eisenmenger's syndrome are entities widely studied. However, its association is unusual and has not been reported. A wide range of gas exchange abnormalities have been describe in both groups. In the severe obese patients this abnormalities are attributed to a ventilation/perfusion mismatch and to an increase pulmonary venous-arterial shunt, that correlates with the lung volume. In severe obese patients with the Eisenmenger's syndrome, this correlation is unknown. Methods: We studied 28 obese subjects paired by body mass index > 30 kg/m². Assigned to two groups, obese with Eisenmenger's syndrome and obese without the syndrome. Clinical variables, respiratory function, echocardiography and gas exchange pre and post-deep breathing maneuver were obtained. Statistical analysis: The variables are expressed with mean±standard deviation. Student t test for paired groups and Pearson correlation coefficient were gathered for the differences and associations between groups. A p-value <0.05 was considered significant. Result: Age was 48.57 ± 10.32 vs 60.86 ± 10.47 y.o. respectively, p < 0.004. Systolic pulmonary arterial pressure 104.36 ± 37 vs 50.1 ± 12 mm Hg, p < 0.001. The arterial oxygen pressure at rest and during the deep breathing maneuver in each group was: 51.64 ± 6.38 vs 57.14 ± 11, p < 0.188 and 56.29 ± 11.15 vs 72 ± 11.83, p < 0.001; venous-arterial shunt 12.79 ± 3.66 vs 13.07 ± 4.84, p < 0.767 and 9.21 ± 3.77 vs 6.5 ± 2.28, p < 0.001; alveolar arterial oxygen difference 271.14 ± 79.92 vs 243.79 ± 92.07, p < 0.001, respectively. Conclusion: Obese subjects with Eisenmenger´s syndrome, did not have significant improvement of gas exchange with the deep breathing maneuver.


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