Document Detail


Noninvasive bilevel positive airway pressure for preoxygenation of the critically ill morbidly obese patient.
MedLine Citation:
PMID:  17766742     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We describe the use of noninvasive bilevel positive airway pressure (BiPAP) in a critically ill, hypoxemic and morbidly obese patient for preoxygenation prior to rapid sequence induction of anesthesia. CLINICAL FEATURES: A critically ill morbidly obese patient (body mass index: 49 kg.m(-2)) was scheduled for urgent laparoscopic cholecystectomy. Preoxygenation with 5 L.min(-1) oxygen flow resulted in a moderate increase in oxygen saturation (SpO2) from 79% to 90%. Prior to rapid sequence induction of anesthesia, a trial of noninvasive BiPAP with oxygen delivery at 5 L.min(-1) increased his SpO2 to 95% initially, with full saturation of 99% achieved when oxygen flow was increased to 10 L.min(-1). Bilevel positive airway pressure with an inspiratory and expiratory pressures of 17 cm H2O and 7 cm H2O, respectively, was applied using a full face mask to achieve a tidal volume of 8 mL.kg(-1). Rapid sequence induction proceeded uneventfully. CONCLUSIONS: Prior to rapid sequence induction of anesthesia in patients with respiratory compromise secondary to factors which reduce FRC, noninvasive BiPAP in combination with supplemental oxygen may be indicated whenever traditional preoxygenation does not provide adequate oxyhemoglobin saturation. Improved oxygenation is most likely attributable to improved ventilation and alveolar recruitment.
Authors:
Mohamad F El-Khatib; Ghassan Kanazi; Anis S Baraka
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  54     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-03     Completed Date:  2007-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  744-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, American University of Beirut, P.O.Box: 11-0236, Beirut 1107 2020, Lebanon.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia, General*
Blood Gas Analysis
Cholecystectomy, Laparoscopic*
Critical Illness*
Humans
Male
Obesity, Morbid / complications*
Oxygen Inhalation Therapy / instrumentation,  methods*
Positive-Pressure Respiration / instrumentation,  methods*

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