Nasal Mask PC Ventilation: A Rescue In A Morbidly Obese OSA Patient During EGD

Proposal Number:

MCC-7153 

Proposal Type:

Medically Challenging Case Report Poster 

Author:

Neel Patel  
Rutgers Robert Wood Johnson Medical School

Co-Author(s):

Sylviana Barsoum  
Rutgers Robert Wood Johnson Medical School
James Tse  
Rutgers Robert Wood Johnson Medical School

Abstract:

A 77y/o female, BMI 35.2kg/m2, with OSA, pulmonary HTN on home NC O2, CAD s/p 3x stents, thoracic/AAA s/p aorta-bifem bypass and melana presented for EGD/colonoscopy. SpO2 was 94% on NC O2 (4L/min). A plastic sheet converted NC to a face tent which increased her SpO2 to 100%. During sedation with lidocaine/propofol, her airway was obstructed and she desaturated to 80%SpO2. A modified infant face mask was immediately secured over her nose and connected to the anesthesia circuit/machine to deliver CPAP (15cm H2O) with 4L O2 /min. Her SpO2 promptly raised to 99%. Her ventilation was then supported with nasal pressure-control ventilation (PIP 17cm H2O, PEEP 14cm H2O, RR 10/min) maintaining 98-100% SpO2. She recovered without any complications.

Professional Category:

Student

Keywords:

General
Other - Airway Management

Supporting Image: 2019PGAEGDMonitor1NPatel.jpg
   ·Monitor showing SpO2 decreased to 80% due to airway obstruction
Supporting Image: 2019PGAEGD1NPatel.jpg
   ·A modified infant mask provided immediate nasal CPAP and PC ventilation
Supporting Image: 2019PGAEGDMonitor2NPatel.jpg
   ·Monitor showing prompt recovery of oxygenation with nasal mask PC ventilation
 

Enter up to two references.

  Reference
1. Anesthesiology 102: 484, 2005; 2. www.TseMask.com