Lodox reveals the ideal body
Lara Nicole Goldstein, Sameer Carim
The Pan African Medical Journal. 2017;27:195. doi:10.11604/pamj.2017.27.195.12822

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Lodox reveals the ideal body

Cite this: The Pan African Medical Journal. 2017;27:195. doi:10.11604/pamj.2017.27.195.12822

Received: 22/05/2017 - Accepted: 15/06/2017 - Published: 13/07/2017

Key words: Ventilation, ideal body weight, critical care, emergency medicine

© Lara Nicole Goldstein et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/27/195/full

Corresponding author: Lara Nicole Goldstein, MBBCh, MMed (Emergency Medicine), Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa (drg666@gmail.com)


Lodox reveals the ideal body

Lara Nicole Goldstein1,&, Sameer Carim1

 

1Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa

 

 

&Corresponding author
Lara Nicole Goldstein, Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa

 

 

Image in medicine    Down

A 110 kg patient presented to the hospital emergency department after being involved in a motor vehicle collision. A full body LODOX® (low-dose digital x-ray) was performed as part of the primary survey. The patient was subsequently intubated for airway protection. The utilisation of lower tidal volumes for ventilation of patients came to the fore with the ARDSNET publication. Despite the now well-known risks of ventilator-associated lung injury, patients with higher body mass indices who require ventilation in the emergency department are at increased risk of receiving inappropriately high tidal volumes. This Lodox image highlights that even though the patient's actual body weight was 110 kg and body mass index greater than 40, the lung size was equivalent to that of a 65 kg person. In addition, obesity can result in reduced lung volumes as well as reduced lung and chest wall compliance. This is exacerbated by the weight of the adipose leading to an increase in the work of breathing. It is a good reminder that in order to avoid deleterious, iatrogenic lung injury, we need to ventilate obese patients with tidal volumes scaled to their ideal body weight and mitigate the decreased chest wall compliance by considering starting with higher PEEP levels.

 

Figure 1: full body lodox image

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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Volume 27 (May - August 2017)

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Figure 1: full body lodox image


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ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved