Document Detail


Positive end-expiratory pressure during induction of general anesthesia increases duration of nonhypoxic apnea in morbidly obese patients.
MedLine Citation:
PMID:  15673897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Positive end-expiratory pressure (PEEP) applied during induction of anesthesia prevents atelectasis formation and increases the duration of nonhypoxic apnea in nonobese patients. PEEP also prevents atelectasis formation in morbidly obese patients. Because morbidly obese patients have difficult airway management more often and because arterial desaturation develops rapidly, we studied the clinical benefit of PEEP applied during anesthesia induction. Thirty morbidly obese patients were randomly allocated to one of two groups. In the PEEP group, patients breathed 100% O(2) through a continuous positive airway pressure device (10 cm H(2)O) for 5 min. After induction of anesthesia, they were mechanically ventilated with PEEP (10 cm H(2)O) for another 5 min until tracheal intubation. In the control group, the sequence was the same but without any continuous positive airway pressure or PEEP. We measured apnea duration until Spo(2) reached 90% and we performed arterial blood gases analyses just before apnea and at 92% Spo(2). Nonhypoxic apnea duration was longer in the PEEP group compared with the control group (188 +/- 46 versus 127 +/- 43 s; P = 0.002). Pao(2) was higher before apnea in the PEEP group (P = 0.038). Application of positive airway pressure during induction of general anesthesia in morbidly obese patients increases nonhypoxic apnea duration by 50%.
Authors:
Sylvain Gander; Philippe Frascarolo; Michel Suter; Donat R Spahn; Lennart Magnusson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  100     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-27     Completed Date:  2005-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  580-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, University Hospital, CHUV BH-10, CH-1011 Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anesthesia, General*
Apnea / etiology*
Blood Gas Analysis
Female
Humans
Male
Middle Aged
Obesity, Morbid / complications*
Oxygen / blood
Positive-Pressure Respiration*
Prospective Studies
Single-Blind Method
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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