High PEEP extubation as guided by esophageal manometry

The ventilatory management of morbidly obese patients presents an ongoing challenge in the Intensive Care Unit (ICU) as multiple physiologic changes in the respiratory system complicate weaning efforts and make extubation more difficult, often leading to increased time on the ventilator. We report t...

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Bibliographic Details
Published in:Respiratory medicine case reports 2024, Vol.48, p.101985-101985
Main Authors: Pendleton, Kathryn M, Fiocchi, Jacob, Meyer, Julia, Fuher, Alexandra, Green, Sarah, LeTourneau, William M, Reilkoff, Ronald A
Format: Report
Language:English
Online Access:Get full text
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Summary:The ventilatory management of morbidly obese patients presents an ongoing challenge in the Intensive Care Unit (ICU) as multiple physiologic changes in the respiratory system complicate weaning efforts and make extubation more difficult, often leading to increased time on the ventilator. We report the case of a young adult male who presented to our ICU on two separate occasions with hypoxemic respiratory failure requiring intubation. Esophageal manometry (EM) guided positive end expiratory pressure (PEEP) titration was utilized during both ICU admissions to improve oxygenation and aid in extubation with spontaneous breathing trials performed on higher-than-normal PEEP settings and successful liberation on both occasions.
ISSN:2213-0071
2213-0071
DOI:10.1016/j.rmcr.2024.101985