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Feasibility of THRIVE oxygenation and intra-operative lung-protective ventilation in morbidly obese patients undergoing neurosurgical procedures
The conduct of anesthesia in morbidly obese patients undergoing neurosurgical procedures can be challenging considering the multi-system organ involvement. Implementation of conventional lung-protective ventilation in morbidly obese patients can have a negative impact on the intra-cranial dynamics....
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311174/ https://www.ncbi.nlm.nih.gov/pubmed/35898536 http://dx.doi.org/10.4103/sja.sja_198_22 |
Sumario: | The conduct of anesthesia in morbidly obese patients undergoing neurosurgical procedures can be challenging considering the multi-system organ involvement. Implementation of conventional lung-protective ventilation in morbidly obese patients can have a negative impact on the intra-cranial dynamics. We report a series of three patients with morbid obesity and a difficult airway for the neurosurgical procedure. The patients were oxygenated with high-flow oxygen devices to ensure an adequate oxygen reserve in the peri-operative period. A modified intra-operative lung-protective ventilation with normocarbia was implemented with no impact on the intra-cranial pressure in the prone position in two of the patients. Oxygenation with high-flow devices should be considered during the peri-operative period in morbidly obese patients to avert an adverse respiratory event, and a modified lung-protective ventilation technique is feasible with normal intra-cranial dynamics intra-operatively. |
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