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

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.