Emergency orthopaedic surgery under noninvasive ventilation after refusal for general anaesthesia.
In this observation, we report a novel use of noninvasive positive pressure ventilation in the operating room to support ventilation in an acidotic hypercapnic patient with severe acute chronic respiratory failure refuted for general anaesthesia, operated under spinal anaesthesia for a femoral fracture. The feasibility of noninvasive ventilatory assistance during surgery performed under regional anaesthesia is reported here. In selected cases, noninvasive ventilation can be used in the management of patients with acute or chronic respiratory failure requiring an urgent surgical intervention but in whom the respiratory status excluded a general anaesthesia.
Thys
Frédéric
F
Emergency Medicine Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium. thys@rean.ucl.ac.be
Delvau
Nicolas
N
Roeseler
Jean
J
Spencer
Sebastian
S
Singelyn
François
F
Manche
Eric
E
Colosi
Luisa
L
Verschuren
Franck
F
D000368:Aged; D000775:Anesthesia, Spinal; D002908:Chronic Disease; D004635:Emergency Medicine / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D011175:Positive-Pressure Respiration / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*