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 / Impact of the deep breathing maneuver in the gas exchange in the subject with severe obesity and pulmonary arterial hypertension associated to Eisenmenger's syndrome

ABSTRACT

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.