Respiratory evaluation through volumetric capnography among grade III obese and eutrophic individuals: a comparative study

BACKGROUND: Excess trunk body fat in obese individuals influences respiratory physiological function. The aims of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is any association between neck circumference (NC), waist-hip ratio (WHR) and VCap among grade III obese individuals. DESIGN AND SETTING:Analytical observational case-matched cross-sectional study, University of Campinas. METHODS: This cross-sectional study compared VCap variables between 60 stage III obese patients and 60 normal-weight individuals. RESULTS: In comparison with the normal-weight group, obese patients presented higher alveolar minute volume (8.92 +/- 4.94 versus 6.09 +/- 2.2; P = < 0.0001), CO2 production (278 +/- 91.0 versus 209 +/- 60.23; P < 0.0001), expiratory tidal volume (807 +/- 365 versus 624 +/- 202; P = 0.005), CO2 production per breath (21.1 +/- 9.7 versus 16.7 +/- 6.16; P = 0.010) and peak expiratory flow (30.9 +/- 11.9 versus 25.5 +/- 9.13; P = 0.004). The end-expiratory CO2 (PetCO(2)) concentration (33.5 +/- 4.88 versus 35.9 +/- 3.79; P = 0.013) and the phase 3 slope were normalized according to expired tidal volume (0.02 +/- 0.05 versus 0.03 +/- 0.01; P = 0.049) were lower in the obese group. CONCLUSIONS: The greater the NC was, the larger were the alveolar minute volume, anatomical dead space, CO2 production per minute and per breath and expiratory volume; whereas the smaller were the phase 2 slope (P2SIp), phase 3 slope (P3SIp) and pressure drop in the mouth during inspiration.