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Feasibility of THRIVE oxygenation and intra-operative lung-protective ventilation in morbidly obese patients undergoing neurosurgical procedures

Title: Feasibility of THRIVE oxygenation and intra-operative lung-protective ventilation in morbidly obese patients undergoing neurosurgical procedures
Authors: Vaithialingam, Balaji; Muthuchellappan, Radhakrishnan
Source: Saudi Journal of Anaesthesia ; volume 16, issue 3, page 361-363 ; ISSN 1658-354X
Publisher Information: Medknow
Publication Year: 2022
Description: 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.
Document Type: article in journal/newspaper
Language: English
DOI: 10.4103/sja.sja_198_22
Availability: https://doi.org/10.4103/sja.sja_198_22; https://journals.lww.com/10.4103/sja.sja_198_22
Accession Number: edsbas.26F8CDDC
Database: BASE