PERIOPERATIVE NON-INVASIVE VENTILATION TO AVERT INTUBATION IN SEPSIS-INDUCED MULTI-ORGAN FAILURE PATIENT UNDERGOING EMERGENCY LOWER-LIMB SURGERY: A CASE REPORT
Non-invasive ventilation (NIV) has proven benefits in critically ill patients over invasive ventilation in indicated patients. The use of NIV is, however, mostly confined to the critical care unit, although it is being used in many patient care set-ups. The use of NIV in operation theatre for caring surgical patients during the surgery is emerging and relatively less reported. We present a case of a 60-year-old lady, a known case of type-II Diabetes Mellitus on oral hypoglycemics with poor compliance to medication, and chronic kidney disease, presented with a diabetic gangrenous foot. She was in sepsis-induced acute hypoxemic respiratory failure and was successfully managed with NIV and spinal anesthesia, and the need for endotracheal intubation and possible consequences were averted. The case highlights the usefulness of NIV in indicated patients requiring surgery, which can be managed by neuraxial anesthesia. The case also highlights the need for dedicated NIV modes in the anesthesia workstation.
2. Mills GH. Respiratory physiology and anaesthesia. Br J Anesth CEPD Rev. 2001;1:35–9.
3. Yuki K, Murakami N. Sepsis pathophysiology and anesthetic consideration. Cardiovasc Hematol Disord Drug Targets. 2015;15:57–69.
4. Brochard L. Mechanical ventilation: invasive versus noninvasive. Eur Respir J. 2003;47:31s-37s.
5. Liu YJ, Zhao J, Tang H. Non-invasive ventilation in acute respiratory failure: a meta-analysis. Clin Med (Lond). 2016;16:514–23.
6. Keenan SP, Sinuff T, Cook DJ, et al. Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review. Crit Care Med. 2004;32:2516-23.
7. Corcione N, Karim HM, Mina BA, et al. Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review. Anesthesiol Intensive Ther. 2019;51:289-98.
8. Kohei Hamada, YoshitsuguChigusa, EijiKondoh, et al.. Noninvasive Positive-Pressure Ventilation for Preeclampsia-Induced Pulmonary Edema: 3 Case Reports and a Literature Review. Case Rep Obstet Gynecol. 2018;2018:7274597.
9. Cabrini L, Nobile L, Plumari VP, et al. Intraoperative prophylactic and therapeutic non-invasive ventilation: A systematic review. Br J Anaesth. 2014;112:638–47.
10. Liu Q, Shan M, Liu J, et al. Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients After Cardiac Surgery. J Surg Res. 2020;246:384-94.
11. Karim HM, Panda CK, Kumar M. et al. Perioperative challenges for same sitting bilateral upper limb surgery in a patient of obstructive sleep apnoea, morbid obesity, hypothyroidism, and orthopnea. Ain-Shams J Anesthesiol. 2018;10:1.
Copyright (c) 2022 Romanian Journal of Emergency Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.