Bariatric surgery postoperative management: complications in a series of 278 patients admitted to an intensive care unit

Introduction

Morbid obesity is one of the most important public health problems these days, and bariatric surgery became an option to patients with body mass index of 35 or higher and obesity-related complications (hypertension, diabetes, etc.).

Patients and methods

We observed the postoperative period of these patients in our ICU during 10 months (n = 278) and their possible postoperative complications.

Results

Found were athelectasy in 60%, surgical wound minor bleeding in 2.5%, pulmonary embolism in 0.35%, pneumonia in 1.43%, acute renal failure in 1.07%, rhabdomyolisis in 2.8%, peritonitis in 1.43%, respiratory failure in 2.5%, acute respiratory distress syndrome in 1.07%, cardiac arrhythmia in 1.43%, gastrointestinal fistula in 2.5%, acute myocardial infarction in 0.72%, lower gastrointestinal hemorrhage in 0.71%, and bowel obstruction in 0.71%. The death overall rate was 1.43%.

Conclusions

The most common postoperative complication was athelectasy, showing the need for a respiratory therapist at the bedside to perform non-invasive mechanical ventilation in the immediate postoperatorium period. Peritonitis was the worst complication, accounting for all deaths; the intensive care team must be prepared to immediately recognize and manage these cases. The results are in accord with those found in the recent medical literature.