High PEEP extubation as guided by esophageal manometry.

Respir Med Case Rep

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.

Published: January 2024

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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865048PMC
http://dx.doi.org/10.1016/j.rmcr.2024.101985DOI Listing

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