A Case Review Obesity and Effective Ventilation Strategies

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PEEP In a meta-analysis of eight RCTs involving 330 surgical patients, positive pressure ventilation with PEEP resulted in favorable effects on day 1 postoperatively in terms of higher PaO 2 /FIO 2 <strong>and</strong> lesser atelectatic areas, compared with mechanical ventilation without PEEP (or zero-PEEP, ZEEP) In morbidly obese patients 10 cm of H 2 O PEEP has been shown to reduce respiratory elastance <strong>and</strong> to improve oxygen exchange PEEP shown to increase esophageal sphincter pressures- reduces the risk of regurgitation Pressure Control with PEEP – studies
Recruitment Maneuvers Recruitment maneuvers – Peak inspiratory pressure of 40 cm Hg for 7-8 sec- increases lung volumes up to vital capacity ARS (alveolar recruitment strategy)- stepwise increase of PEEP/inspiratory pressures (e.g., 0/10, 5/15, 10/20, 15/25 cm H 2 O) over 8 to 10 respiratory cycles Applying a continuous positive airway pressure (CPAP) over 10-30 s
Page 1 and 2: A Case Review Obesity and Effective
Page 3 and 4: Case Scenario 42 year old female p
Page 5 and 6: How will you ventilate
Page 8 and 9: Respiratory Physiology in Obesity
Page 10 and 11: During Anesthesia (continued) Decr
Page 12 and 13: Effective ventilation vs. preventio
Page 14 and 15: Peak pressure vs. plateau pressure
Page 16 and 17: Volume control
Page 20 and 21: Protective ventilation strategies
Page 22 and 23: Summary Was the pressure control
Page 24 and 25: Treat the cause / Change the settin
Page 26 and 27: References: Pelosi P and Greforett

A Case Review Obesity and Effective Ventilation Strategies

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