Ranjha Shahroze A, Pressler Mark P, Blank Randal S, Schirmer Bruce D, Lesh Ryan E
From the University of Virginia School of Medicine, Charlottesville, Virginia.
Departments of Anesthesiology.
A A Pract. 2023 Oct 6;17(10):e01724. doi: 10.1213/XAA.0000000000001724. eCollection 2023 Oct 1.
Endoscopic sleeve gastroplasty (ESG) is a safe and minimally invasive procedure for the treatment of obesity. We report the case of a patient with obesity who underwent ESG complicated by postprocedural respiratory failure. During the procedure, she developed a Pao2/fraction of inspired oxygen (Fio2) ratio that necessitated postoperative mechanical ventilation. Chest radiography demonstrated massively dilated loops of bowel, cephalad displacement of both hemidiaphragms, lung volume reduction, and atelectasis. With absorption of luminal carbon dioxide, she was weaned from mechanical ventilation to supplemental oxygen, and she recovered completely. This case highlights postoperative respiratory failure associated with mechanical loading of the respiratory system following ESG.
内镜袖状胃成形术（ESG）是一种治疗肥胖症的安全且微创的手术。我们报告了一例肥胖患者接受ESG后并发术后呼吸衰竭的病例。在手术过程中，她出现了动脉血氧分压（Pao2）与吸入氧分数（Fio2）比值异常，术后需要机械通气。胸部X线检查显示肠袢大量扩张、双侧膈肌向上移位、肺容积减小和肺不张。随着管腔内二氧化碳的吸收，她从机械通气撤机改为吸氧，并完全康复。该病例突出了ESG后与呼吸系统机械负荷相关的术后呼吸衰竭。
