Osa poser module
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Intraoperatively, ventilatory strategies, such as recruitment maneuvers with positive end-expiratory pressure, may reduce atelectasis and improve oxygenation. In patients with anticipated difficult airways, preparations should be made for awake tracheal intubation. New generation double-lumen supraglottic airway devices provide higher leak pressures and may be safer in obese patients, and they can also provide a conduit for bronchoscopic intubation.
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Tracheal tube introducers or intubating stylets can assist tracheal intubation when suboptimal laryngeal views are obtained, and video laryngoscopy may help improve the glottic view and success of tracheal intubation. Laryngeal exposure during direct laryngoscopy is best achieved with the patient in the “ramped” position. Difficulties in bag and mask ventilation may occur. Preoxygenation can be optimized by a head-up or reverse Trendelenburg position, continuous positive airway pressure, and pressure support ventilation. The combination of excess adipose tissue deposition, increased oxygen consumption, reduced lung volumes, and increased airway resistance in obese patients increases the risk of a difficult airway and rapid oxygen desaturation in the perioperative period.
#Osa poser module professional#
The purpose of this Continuing Professional Development module is to describe anatomic and physiologic challenges in obese patients, review their effects on oxygenation and airway management, and propose strategies for perioperative management.