A new study reports that patients with metabolic syndrome who have weight loss surgery are more likely to experience complications associated with the pulmonary system. A previous study done by Tufts Medical Center found that nearly 1% of patients who had pulmonary complications including atelectasis, pneumothorax or pneumonia had a history of metabolic syndrome.
Published in the February Issue of Clinical Anesthesiology, the study found that comorbid conditions of MetS (metabolic syndrome) such as high blood pressure, glucose intolerance and obesity oftentimes improved after bariatric surgery occurred. Researchers found that MetS who had bariatric surgery has not been studied closely enough to draw large conclusions.
The Tufts study looked at 158,405 different procedures with 52% being gastric bypass, 40% gastric banding and 4% gastric sleeve. Pulmonary complications in these surgeries included respiratory failure, pleural effusion, pneumonia, atelectasis, and acute respiratory distress syndrome. 78.5% of those studied were women with an average age of 45.7.
Nearly 20,158 of these patients had Metabolic syndrome or 12.7% total. The study found a close link to those with MetS and all pulmonary complications except pneumothorax, which was seen mostly in patients without MetS diagnosis. Respiratory failure and pneumonia were common for metabolic syndrome patients.
Researchers are trying to determine whether it is the existence of MetS that impairs the post-op processor if it is a combination of comorbidities that are responsible for this increased risk for complications in these patients. The researchers of both studies believe that medical testing is needed in order to draw a larger conclusion about this.
The Tufts’ study’s author, Dr. Schumann, believes that maybe these patients are just sicker and it makes sense that they run into more trouble after surgery. However, he also believes that it may be a combination of changes in the body that puts these patients at a higher risk for certain outcomes. Many suspects that inflammatory changes in the body may play an important role. This is where the next study should pick up from where these researchers left off.
Many of the researchers believe that the problem lies in the definition of the disease, however, many experts do believe it is the disease and not any comorbidities individually that cause this greater risk for patients. Once this is understood, patients with the Metabolic syndrome can be warned prior to having surgery for these complications.
Another Instance of Pulmonary Problems
In a 2013 PostGraduate Assembly, some researchers found that obstructive sleep apnea diagnoses and being overweight predicted a patient’s individual odds of being transferred to a step-down unit after surgery. They found that patients who used CPAP (continuous positive airway pressure) machines at home automatically continued on postoperatively. However, no word on the increased pressure in the esophagus down to the stomach was mentioned in regards to affecting the surgical site.
Whatever the instance, anything that affects the pulmonary system should be closely monitored and evaluated prior to weight loss surgery to prevent any dangerous life-threatening complications from occurring to patients.