Noninvasive bilevel positive airway pressure for preoxygenation of the critically ill morbidly obese patient

Preoxygenation, Reoxygenation, and Delayed Sequence Intubation in the Emergency Department

“…With a setting of continuous positive airway pressure (CPAP) at 0 cm H 2 O, this NIV set-up will simply provide a source of nearly 100% oxygen. With increased CPAP settings, shunt can actually be treated and the patient's oxygenation significantly improved (11)(12)(13)(14)(15).…”

Non-invasive mechanical ventilation with spinal anesthesia for cesarean delivery

“…Non-invasive mechanical ventilation is most commonly performed in ICU, on chest disease wards, and in the ER; 2 however, it can also be used for preoxygenation and postoperative recovery in patients with respiratory issues following major surgery. 2,3 The intraoperative use of NIMV is rarely reported, 2,4,5,11 although BiPAP during vaginal delivery with spinal analgesia has been described. 12 In our case, BiPAP was used preoperatively, and when positioning for spinal anesthesia became difficult due to continued dyspnea and orthopnea.…”

“…1 Non-invasive mechanical ventilation (NIMV) is a commonly accepted treatment for chronic and acute respiratory insufficiency, 2 and is an effective tool in promoting oxygenation pre-and postoperatively. 2,3 Only a limited number of cases and studies have reported its intraoperative use. 2,4,5 We present the case of a morbidly obese pregnant woman with respiratory distress and pulmonary edema secondary to severe preeclampsia and bronchial asthma who was managed with spinal anesthesia and perioperative NIMV for emergency cesarean delivery.…”

THRIVE – atelectasis, hypercarbia and consent

“…We would like to re-emphasise that a combination of methods, allied to the standard of pre-oxygenation monitored using end-tidal concentration, may provide the safest approach during induction. Pre-oxygenation with assisted spontaneous breathing and positive end-expiratory pressure may be of additional benefit in improving oxygenation in the obese patient [11,12] We would like to congratulate Drs Patel and Nouraei for their breakthrough work in this area of apneic oxygenation, and agree that the technique has the potential to change fundamentally the assessment and management of patients with difficult airways [1]. However, we would like to ask the authors two questions about potential problems with their technique.…”