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Obese patients can be difficult to preoxygenate, and they have more-rapid desaturation than do nonobese patients. Investigators in France compared noninvasive positive pressure ventilation (NPPV) and spontaneous ventilation (SV) for preoxygenation for intubation in 28 morbidly obese patients who were undergoing general anesthesia for elective surgery. Patients randomized to NPPV received 100% oxygen with pressure support of 6 cm H2O and positive end-expiratory pressure (PEEP) of 4 cm H2O for 20 seconds, followed by pressure support of 8–10 cm H2O and PEEP of 6 cm H2O to achieve a tidal volume of at least 8 mL/kg of ideal body weight. The SV group received 100% oxygen via an anesthesia circuit at 18 L/minute flow.
Significantly more patients …