Morbidly obese patients undergoing laparoscopic surgery: Ventilator and airway management
Yi Deng
Baylor College of Medicine, USA
: J Surg Clin Pract
Abstract
Obesity and morbid obesity in particular has dramatically risen in the last 2 decades in many countries exposed to the Western diet, and is followed by a significant increase in the incidence of cardiopulmonary, hepatobiliary, renal, and metabolic diseases. These patients frequently present for routine surgeries such as laparoscopic cholecystectomies but due to their body habitus and comorbidities offer a wide array of anesthetic management challenges during and after surgery. Securing an airway can be daunting and there has been a proliferation of new intubating equipment and techniques in the last decade, some of which will be reviewed here. Moreover, adjunct practices such as Hi-Flo nasal cannula, noninvasive positive pressure ventilation, apneic oxygenation, and even patient positioning will be given an evidence-based review. The second part of the presentation will be focused on ventilator management, with a focused overview on transpulmonary and driving pressures, before delving into PEEP/tidal volume strategies to minimize ventilator induced lung injury while prevent atelectasis formation and postoperative pulmonary complications. This presentation is aimed at improving surgeons and anesthesiologists’ intraoperative knowledge of airway management for morbidly obese patients, as well as examines our current practice of ventilator management in this challenging subset of patient population.
Biography
Yi Deng graduated from Johns Hopkins School of Medicine in Baltimore, USA in 2010. He completed his anesthesiology residency training at Baylor College of Medicine in Houston, Texas, and obtained 2 fellowships, one in cardiothoracic anesthesiology and one in critical care medicine. He currently practices as an assistant professor of anesthesiology and critical care medicine at Baylor College of Medicine and also serves as the associate director of cardiothoracic anesthesiology.
E-mail: yd1@bcm.edu
