Steep Trendelenburg positioning

 

List of problems:

Airway

·     Endobronchial intubation

·     Regurgitation -> aspiration upon flattening

·     Oedema -> CICO at extubation

Breathing

·     Alveolar collapse -> ↓oxygenation

·     Restrictive deficit -> ↓ventilation

          *Exacerbated in obesity*

Circulation

·     ↑Venous return -> ↑CVP -> masking of intra-op blood loss

·     Risk of profound hypotension on return to supine

Disability/neuro

·     ↑ICP -> oedema -> risk narcosis and respiratory depression

·     ↑IOP -> risk blindness

External

·     Sliding off the table

·     Brachial plexus injury

·     Compartment syndrome

·     Rhabdomyolysis

 

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