PERIOPERATIVE NON-INVASIVE VENTILATION TO AVERT INTUBATION IN SEPSIS-INDUCED MULTI-ORGAN FAILURE PATIENT UNDERGOING EMERGENCY LOWER-LIMB SURGERY: A CASE REPORT

Abhishek   Bharadwaj; Habib Md Reazaul Karim; Javaid  Iqbal; Manu P  Kesavankutty

doi:10.33695/rojes.v3i2.29

Abhishek Bharadwaj Department of Anesthesiology and Critical Care. All India Institute of Medical Sciences, Raipur. India.
Habib Md Reazaul Karim Department of Anaesthesiology, Critical Care and Pain Mediicne. All India Institute of Medical Sciences Raipur
Javaid Iqbal Department of Anesthesiology and Critical Care. All India Institute of Medical Sciences, Raipur. India
Manu P Kesavankutty Department of Anesthesiology and Critical Care. All India Institute of Medical Sciences, Raipur. India

DOI: https://doi.org/10.33695/rojes.v3i2.29

Keywords: Noninvasive Ventilation, Acute Care, Surgery, Acute Respiratory Failure

Abstract

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.

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