Ramping Position to Aid Non-invasive Ventilation (NIV) in Obese Patients in the ICU

INTRODUCTION: The ramping position is recommended to facilitate pre-oxygenation and mask ventilation of obese patients in anaesthetics via improving the airway alignment. PRESENTATION OF CASE SERIES: Two cases of obese patients admitted to the intensive care unit (ICU) with type 2 respiratory failure. Both cases showed obstructive breathing patterns on non-invasive ventilation (NIV) and failed resolution of hypercapnia. Ramping position alleviated the obstructive breathing pattern and hypercapnia was subsequently resolved. CONCLUSION: There are no available studies on the rule of the ramping position in aiding NIV in obese patients in the ICU. Accordingly, this case series is significantly important in highlighting the possible benefits of the ramping position for obese patients in settings other than anaesthesia.