, 1993) The absence of any difference in TI/TTOT between obese p

, 1993). The absence of any difference in TI/TTOT between obese patients and controls can be explained by the progressive adaptation of the respiratory system as weight increases. According to Domingos-Benício et al. (2004), individuals who have been obese for a long

time can adapt to the overload imposed by the adipose tissue. There were no significant differences in VT/TI between the two groups. According to Tobin et al. (1983b), the VT/TI ratio reflects the respiratory drive, and obese individuals do not exhibit alteration in ventilatory drive ( Sampson and Grassino, 1983). Cavallazzi et al. (1981) evaluated the ventilation of obese individuals after the inhalation selleck of carbonic gas and observed that despite high variability, all individuals showed an adequate response

to the stimulus. Chlif et al. (2009) evaluated 34 obese patients and did not find differences in the VT/TI from normal values. Weight stabilization usually occurs 1 year after surgery. buy XL184 In this study, patients were only followed for 6 months, which may have influenced the results and is a limitation of this study. Another point to be discussed is that sample size calculated after a pilot study with 10 subjects in each group demonstrated the need of more them 1571 subjects. This number is very high and impossible to be attained on this study. Most of the study related to this field had studied about 30 patients. Moreover, even with only 30 subjects on each group it was possible to verify significant differences in most of the variables, showing a positive effect of the weight loss. Significant differences were not found in %RC or %AB. Both groups had high levels of abdominal motion, results that corroborate those observed by Tobin et al. (1983b) in normal individuals and those with other respiratory diseases (Tobin et al.,

1983a). The PhAng, a variable that reflects asynchrony on thoracoabdominal motion, has been studied in healthy and patients (Aliverti et al., 2009, Alves et al., 2008, Oliveira et al., 2009 and Parreira et al., 2010) Our Lenvatinib in vivo results showed that at preoperative period and at 1 month after surgery, obese patients exhibited higher PhAng values than the control group. Tobin et al. (1987) reported that an increased thoracoabdominal asynchrony is associated with an increase in respiratory load, influencing the elastic withdrawal of the rib cage and lungs (Biring et al., 1999 and Lazarus et al., 1998). The existence of higher asynchrony 1 month after surgery can be attributed to insufficient weight reduction to decrease the overload to the thoracic wall and, also, to postoperative discomfort because patients were still experiencing some pain and discomfort caused by the surgery (Ford et al., 1993). No significant reduction in PhAng was seen at 6 months after surgery compared to preoperative and after 1 month.

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