Regimens of controlled ventilation of lungs at the stages of surgical treatment of patients with morbid obesity (review)

The article presents a literature review of the current state of the problem of intraoperative use of various modes and procedures of mechanical ventilation (MV) in patients with morbid obesity (MO). Maintaining adequate oxygenation to avoid damage to the lungs during MV conduction continues to be a serious problem in patients with MO and not fully resolved. There are discouraging approaches to ventilation regimes, there is no clarity about the patient’s favorable situation, the optimal level of positive end-expiratory pressure (PEEP) in the implementation of pre-oxygenation. It is believed that there is no difference between the use of ventilation with pressure and volume control, both regimes have an equal effect on gas exchange, airway pressure and mean arterial pressure. If the researchers do not distinguish the difference in the controlled ventilation with the control of pressure and volume in patients with a BMI of up to 50 kg/m2, then there are no data on patients with a super obesity. There were not conducted large-scale studies with sufficient evidence base, which could form the basis of the protocols (for example, Cochran collaboration). These unresolved issues are the basis for the development of domestic recommendations for mechanical ventilation during operations in patients with MO.