TWO SUCCESSFUL CASES OF PERIOPERATIVE MANAGEMENT USING BiPAP VENTILATION SYSTEMS IN PATIENTS WITH CHRONIC RESPIRATORY FAILURE

Abstract

We report two successful cases of perioperative respiratory management using Bi-level positive airway pressure (BiPAP) system in patients with chronic respiratory failure. Case 1: An 83-year-old man was admitted to the hospital with a diagnosed of cholangitis. He had a considerably decreased value of 530ml (21%) of FEV1.0 due to pulmonary emphysema and bronchial asthma. Diagnosed as having choledocholithiasis following a cholecystectomy, a choledocholithotomy and a choledochoduodenostomy were performed. Case 2: A 32-year-old woman, diagnosed as having cholecystocholedocholithiasis, had a considerably decreased value of 850ml (31%) of vital capacity due to muscular dystrophy. She underwent a cholecystectomy and a choledocholithotomy with minor laparotomy. In both cases, operation was performed under epidural and venous anesthesia without using a muscle relaxant and tracheal intubation. During operation, respiratory management was performed using BiPAP, and the two patients successfully weaned from ventilation without pulmonary complications. BiPAP is a noninvasive ventilation system of continuous positive airway pressure (CPAP). To our knowledge, there have been few reported cases of its use for perioperative management in gastrointestinal surgery. On the basis of the present experience, BiPAP system can be a useful application for treating a patient with chronic respiratory failure.