Effect of reverse Trendelenburg position and positive pressure ventilation on safe non-hypoxic apnea period in obese, a randomized-control trial.
Obesity
Positioning
Positive Pressure
Preoxygenation
Safety
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
08 06 2023
08 06 2023
Historique:
received:
23
10
2022
accepted:
07
05
2023
medline:
12
6
2023
pubmed:
9
6
2023
entrez:
8
6
2023
Statut:
epublish
Résumé
There is an elevated incidence of hypoxemia during the airway management of the morbidly obese. We aimed to assess whether optimizing body position and ventilation during pre-oxygenation allow a longer safe non-hypoxic apnea period (SNHAP). Fifty morbidly obese patients were recruited and randomized for this study. Patients were positioned and preoxygenated for three minutes in the ramp position associated with spontaneous breathing without additional CPAP or PEEP (RP/ZEEP group) or in the reverse Trendelenburg position associated with pressure support ventilation mode with pressure support of 8 cmH The SNHAP was significantly longer in the RT/PPV group (258.2 (55.1) vs. 216.7 (42.3) seconds, p = 0.005). The RT/PPV group was also associated to a shorter time to obtain a fractional end-tidal oxygen concentration (FEtO In the morbidly obese population, RT/PPV, compared to RP/ZEEP, lengthens the SNHAP, decreases the time to obtain optimal preoxygenation conditions, and allows a faster resuming of secure oxygen saturation. The former combination allows a more significant margin of time for endotracheal intubation and minimizes the risk of hypoxemia in this highly vulnerable population. NCT02590406, 29/10/2015.
Identifiants
pubmed: 37291541
doi: 10.1186/s12871-023-02128-7
pii: 10.1186/s12871-023-02128-7
pmc: PMC10249289
doi:
Substances chimiques
Oxygen
S88TT14065
Banques de données
ClinicalTrials.gov
['NCT02590406']
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
198Informations de copyright
© 2023. The Author(s).
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