Tissue Oxygenation in Obese and Non-Obese Patients During Laparoscopy

Obes Surg. Jun-Jul 2005;15(6):813-9. doi: 10.1381/0960892054222867.

Abstract

Background: Wound infection risk is inversely related to subcutaneous tissue oxygenation, which is reduced in obese patients and may be reduced even more during laparoscopic procedures.

Methods: We evaluated subcutaneous tissue oxygenation (PsqO(2)) in 20 patients with a body mass index (BMI) > or=40 kg/m(2) (obese group) and 15 patients with BMI <30 kg/m(2) (non-obese group) undergoing laparoscopic surgery with standardized anaesthesia technique and fluid administration. Arterial oxygen tension was maintained near 150 mmHg. PsqO(2) was measured from a surrogate wound on the upper arm.

Results: A mean FIO(2) of 51% (13%) was required in obese patients to reach an arterial oxygen tension of 150 mmHg; however, a mean FIO(2) of only 40% (7%) was required to reach the same oxygen tension in non-obese patients (P=0.007). PsqO(2) was significantly less in obese patients: 41 (10) vs 57 (15) mmHg (P<0.001).

Conclusion: Obese patients having laparoscopic surgery require a significantly greater FIO(2) to reach an arterial oxygen tension of about 150 mmHg than non-obese patients; they also have significantly lower subcutaneous oxygen tensions. Both factors probably contribute to an increased infection risk in obese patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Gastroplasty
  • Humans
  • Laparoscopy
  • Middle Aged
  • Obesity, Morbid / metabolism*
  • Obesity, Morbid / surgery
  • Oxygen / blood
  • Oxygen / metabolism*
  • Pneumoperitoneum, Artificial
  • Surgical Wound Infection / metabolism

Substances

  • Oxygen