PDF(Pubmed)
Abstract：
BACKGROUND: Morbidly obese patients occasionally have respiratory problems owing to hypoventilation. Airway pressure release ventilation is one of the ventilation settings often used for respiratory management of acute respiratory distress syndrome. However, previous reports indicating that airway pressure release ventilation may become a therapeutic measure as ventilator management in morbid obesity with respiratory failure is limited. We report a case of markedly improved oxygenation in a morbidly obese patient after airway pressure release ventilation application.
METHODS: A 50s-year-old Asian man (body mass index 41 kg/m2) presented with breathing difficulties. The patient had respiratory failure with a PaO2/FIO2 ratio of approximately 100 and severe atelectasis in the left lung, and ventilator management was initiated. Although the patient was managed on a conventional ventilate mode, oxygenation did not improve. On day 11, we changed the ventilation setting to airway pressure release ventilation, which showed marked improvement in oxygenation with a PaO2/FIO2 ratio of approximately 300. We could reduce sedative medication and apply respiratory rehabilitation. The patient was weaned from the ventilator on day 29 and transferred to another hospital for further rehabilitation on day 31.
CONCLUSIONS: Airway pressure release ventilation ventilator management in morbidly obese patients may contribute to improving oxygenation and become one of the direct therapeutic measures in the early stage of critical care.
METHODS: A 50s-year-old Asian man (body mass index 41 kg/m2) presented with breathing difficulties. The patient had respiratory failure with a PaO2/FIO2 ratio of approximately 100 and severe atelectasis in the left lung, and ventilator management was initiated. Although the patient was managed on a conventional ventilate mode, oxygenation did not improve. On day 11, we changed the ventilation setting to airway pressure release ventilation, which showed marked improvement in oxygenation with a PaO2/FIO2 ratio of approximately 300. We could reduce sedative medication and apply respiratory rehabilitation. The patient was weaned from the ventilator on day 29 and transferred to another hospital for further rehabilitation on day 31.
CONCLUSIONS: Airway pressure release ventilation ventilator management in morbidly obese patients may contribute to improving oxygenation and become one of the direct therapeutic measures in the early stage of critical care.
摘要：
背景：病态肥胖患者偶尔会由于通气不足而出现呼吸问题。气道压力释放通气是经常用于急性呼吸窘迫综合征的呼吸管理的通气设置之一。然而,以前的报告表明,气道压力释放通气可能成为一种治疗措施,因为病态肥胖伴呼吸衰竭的呼吸机管理有限.我们报告了一例病态肥胖患者在气道压力释放通气后，氧合明显改善的情况。
方法：一名50岁的亚裔男子（体重指数41kg/m2）出现呼吸困难。患者出现呼吸衰竭，PaO2/FIO2比值约为100，左肺严重肺不张，并启动呼吸机管理。尽管患者接受了传统的通气模式，氧合没有改善。在第11天，我们将通气设置更改为气道压力释放通气，在PaO2/FIO2比率约为300的情况下，氧合得到了显着改善。我们可以减少镇静药物并进行呼吸康复。患者在第29天从呼吸机上断奶，并在第31天转移到另一家医院进行进一步康复。
结论：病态肥胖患者的气道压力释放通气呼吸机管理可能有助于改善氧合，并成为重症监护早期的直接治疗措施之一。
方法：一名50岁的亚裔男子（体重指数41kg/m2）出现呼吸困难。患者出现呼吸衰竭，PaO2/FIO2比值约为100，左肺严重肺不张，并启动呼吸机管理。尽管患者接受了传统的通气模式，氧合没有改善。在第11天，我们将通气设置更改为气道压力释放通气，在PaO2/FIO2比率约为300的情况下，氧合得到了显着改善。我们可以减少镇静药物并进行呼吸康复。患者在第29天从呼吸机上断奶，并在第31天转移到另一家医院进行进一步康复。
结论：病态肥胖患者的气道压力释放通气呼吸机管理可能有助于改善氧合，并成为重症监护早期的直接治疗措施之一。
