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Pulmonary function in morbid obesity.

H J Sugerman1

  • 1Medical College of Virginia, Virginia Commonwealth University, Richmond.

Gastroenterology Clinics of North America
|June 1, 1987
PubMed
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Gastric surgery significantly improves respiratory issues in morbidly obese patients, including sleep apnea syndrome and obesity hypoventilation syndrome. Weight loss corrects breathing problems, making bariatric surgery a key treatment for obesity-related respiratory insufficiency.

Area of Science:

  • Bariatric Surgery
  • Pulmonary Medicine
  • Obesity Medicine

Background:

  • Morbid obesity frequently causes severe respiratory impairment.
  • Respiratory insufficiency in obesity includes obstructive sleep apnea syndrome (SAS) and obesity hypoventilation syndrome (OHS), with Pickwickian syndrome being the most severe form.
  • Approximately 10% of morbidly obese patients undergoing gastric surgery exhibit severe respiratory impairment.

Purpose of the Study:

  • To evaluate the impact of surgically induced weight loss on respiratory insufficiency in morbidly obese patients.
  • To assess the effectiveness of different bariatric procedures in managing obesity-related breathing disorders.

Main Methods:

  • A series of 59 morbidly obese patients with obesity-related respiratory insufficiency underwent gastric surgery for weight reduction.

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  • Patients were categorized based on the presence of OHS, SAS, or both.
  • Outcomes included excess weight loss, mortality rates, and improvements in respiratory parameters.

    • Main Results:

    • Overall, morbidly obese patients lost 67% of excess weight after gastric procedures.
    • Respiratory insufficiency significantly improved or resolved post-surgery, with enhanced arterial oxygenation, reduced CO2 retention, expanded lung volumes, corrected polycythemia, and decreased apnea frequency.
    • Specific procedures like gastric bypass for 'sweets eaters' and vertical banded gastroplasty for 'gorgers' showed favorable outcomes, with average excess weight loss of two-thirds and correction of breathing problems.

    Conclusions:

    • Surgically induced weight loss is highly effective in improving or correcting respiratory insufficiency secondary to morbid obesity.
    • Respiratory insufficiency associated with obesity should be considered a primary indication for aggressive weight reduction strategies.
    • Gastric bypass and vertical banded gastroplasty are recommended procedures, offering significant weight loss and resolution of associated breathing issues.