title: Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity.
abstract: OBJECTIVE
  Aerobic capacity and respiratory function may be compromised in obesity, but few studies have been done in highly obese bariatric candidates. In a prospective study, these variables were documented in the preoperative period, aiming to define possible physiologic limitations in a apparently healthy and asymptomatic population.
  
  
  METHODS
  Forty-six consecutively enrolled adults (age 39.6 +/- 8.4 years, 87.0% females, body mass index /BMI 49.6 +/- 6.3 kg/m2) were analyzed. Ventilatory variables were investigated by automated spirometry, aerobic capacity was estimated by a modified Bruce test in an ergometric treadmill, and body composition was determined by bioimpedance analysis.
  
  
  RESULTS
  Total fat was greatly increased (46.4 +/- 4.6% of body weight) and body water reduced (47.3 +/- 4.6 % body weight), as expected for such obese group. Spirometric findings including forced vital capacity of 3.3 +/- 0.8 L and forced expiratory volume-1 second of 2.6 +/- 0.6 L were usually acceptable for age and gender, but mild restrictive pulmonary insufficiency was diagnosed in 20.9%. Aerobic capacity was more markedly diminished, as reflected by very modest maximal time (4.5 +/- 1.1 min) and distance (322 +/-142 m) along with proportionally elevated maximal oxygen consumption (23.4 +/- 9.5 mL/kg/min) achieved by these subjects during test exercise.
  
  
  CONCLUSIONS
  1) Cardiopulmonary evaluation was feasible and well-tolerated in this severely obese population; 2) Mean spirometric variables were not diminished in this study, but part of the population displayed mild restrictive changes; 3) Exercise tolerance was very negatively influenced by obesity, resulting in reduced endurance and excessive metabolic cost for the treadmill run; 4) More attention to fitness and aerobic capacity is recommended for seriously obese bariatric candidates;
authors.affiliation: Division of Surgery II, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. jfaintuch@hcnet.usp.br
authors.forename: Joel
authors.initials: J
authors.lastname: Faintuch
authors.forename: Shirley A F
authors.initials: SA
authors.lastname: Souza
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Valezi
authors.forename: Antonio F
authors.initials: AF
authors.lastname: Sant'Anna
authors.forename: Joaquim José
authors.initials: JJ
authors.lastname: Gama-Rodrigues
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005080:Exercise Test; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D011300:Preoperative Care; D011446:Prospective Studies; D012119:Respiration; D013147:Spirometry