Controversies in the Anesthetic Management of the Obese Surgical Patient by Yigal Leykin & Jay B. Brodsky

Author:Yigal Leykin & Jay B. Brodsky
Language: eng
Format: epub
Publisher: Springer Milan, Milano

14.5 What is the Best Way to Preoxygenate?

A negative consequence of allowing any patient to breathe 100% oxygen is atelectasis that follows uptake of oxygen from poorly ventilated alveoli which are no longer splinted open by inert nitrogen. Lung atelectasis develops immediately after induction of general anesthesia and paralysis in all human subjects. The lung volume decreases by half a liter in non-obese persons but recovers within 24 h after minor surgery. Importantly, the atelectasis and lung volume reduction are more severe in obese patients than non-obese patients and sustained for more than 24 h, even after minor surgery, causing hypoxemia during and after surgery. Accordingly, the establishment of an effective airway-management strategy for preventing atelectasis in obese patients is clinically significant.

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