Document Detail


Efficacy of preoxygenation with non-invasive low positive pressure ventilation in obese patients: Crossover physiological study.
MedLine Citation:
PMID:  22770916     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The impact of non-invasive positive pressure ventilation (NIPPV), which is a combination of inspiratory positive airway pressure (IPAP) and positive end expiratory pressure (PEEP), on the effectiveness of preoxygenation in obese patients was evaluated. DESIGN: Randomized, controlled, double blinded, crossover study comparing NIPPV vs. tidal volume breathing (TVB) with regard to the expiratory O(2) fraction (FeO(2)). PATIENTS AND METHODS: Thirty participants with body mass index (BMI) greater or equal to 30kg/m(2) scheduled for elective surgery were included. Patients with facial hair, and airway anomalies were excluded. Each patient underwent 3 minutes 100% O(2) preoxygenation with the two following methods in a random order: 1: TVB; 2: NIPPV (4 cmH(2)O IPAP+4 cmH(2)O PEEP). Primary outcome was FeO(2) after 3minutes. Secondary outcomes were the number of patients reaching FeO(2) greater or equal to 90%, tidal volume, respiratory rate, and patient comfort on a 4-point scale. RESULTS: No differences between methods were found regarding the FeO(2) change with time or after 3minutes (89±6% with TBV vs. 91±4% with NIPPV). FeO(2) greater or equal to 90% was reached more frequently with NIPPV (80%) than with TVB (60%) (P=0.008). Tidal volume (m±SD) was larger throughout preoxygenation with TBV (837±440mL) than with NIPPV (744±368mL), (P=0.0005). Respiratory rate did not differ between regimens. Patient comfort was good and similar. CONCLUSION: This study suggests that providing a positive pressure of 4 cmH(2)O throughout inspiration and expiration during preoxygenation in obese patients provided benefits with regard to the FeO(2).
Authors:
M Georgescu; I Tanoubi; L-P Fortier; F Donati; P Drolet
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-6
Journal Detail:
Title:  Annales francaises d'anesthesie et de reanimation     Volume:  -     ISSN:  1769-6623     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8213275     Medline TA:  Ann Fr Anesth Reanim     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.
Affiliation:
Département d'anesthesiologie, hôpital Maisonneuve-Rosemont, centre affilié à l'université de Montréal, 5415, boulevard de l'Assomption, Montréal (Québec) Canada, H1T 2M4.
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