Pressure for High Positive End-expiratory Pressure in Obese Surgical Patients Is Growing.

Editorial| September 2023 Pressure for High Positive End-expiratory Pressure in Obese Surgical Patients Is Growing This article has an Audio Podcast Hermann Wrigge, M.D., Ph.D.; Hermann Wrigge, M.D., Ph.D. 1Department of Anesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital Halle, Halle, Germany; Medical Faculty, Martin-Luther University Halle-Wittenberg, Halle, Germany. https://orcid.org/0000-0002-9035-6822 Search for other works by this author on: This Site PubMed Google Scholar David Petroff, M.Sc., Ph.D.; David Petroff, M.Sc., Ph.D. 2Clinical Trial Centre, University of Leipzig, Leipzig, Germany. Search for other works by this author on: This Site PubMed Google Scholar Ana Fernandez-Bustamante, M.D., Ph.D. Ana Fernandez-Bustamante, M.D., Ph.D. 3Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information This editorial accompanies the articles on pp. 249 and 262. Accepted for publication June 20, 2023. Address correspondence to Dr. Wrigge: hermann.wrigge@bergmannstrost.de Anesthesiology September 2023, Vol. 139, 239–243. https://doi.org/10.1097/ALN.0000000000004665 Connected Content Article: Individualized Positive End-expiratory Pressure on Postoperative Atelectasis in Patients with Obesity: A Randomized Controlled Clinical Trial Article: Individualized Positive End-expiratory Pressure Titration Strategies in Superobese Patients Undergoing Laparoscopic Surgery: Prospective and Nonrandomized Crossover Study Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Hermann Wrigge, David Petroff, Ana Fernandez-Bustamante; Pressure for High Positive End-expiratory Pressure in Obese Surgical Patients Is Growing. Anesthesiology 2023; 139:239–243 doi: https://doi.org/10.1097/ALN.0000000000004665 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: obesity, positive end-expiratory pressure, surgical procedures, operative Setting the best positive end-expiratory pressure (PEEP) in patients with obesity is a challenge for anesthesiologists, as addressed by two featured articles in this issue of Anesthesiology.1,2 Using different approaches for identifying the optimal PEEP level, both studies found individualized PEEP levels to be greater than 15 cm H2O in obese (body mass index 30 kg/m2 or greater)1 and superobese (body mass index 50 kg/m2 or greater) patients.2 Obese patients may present to the operating room with lower peripheral oxygen saturation since their end-expiratory lung volume is more than 20% lower than normal.3 As we induce general anesthesia and start mechanical ventilation, end-expiratory lung volume decreases further by about 50%.4 This is associated with hypoxemia and shortens the apneic time available for airway management. The extremely low end-expiratory lung volume is primarily due to atelectasis, and it may... You do not currently have access to this content.