The goal of this study is to compare two continuous positive airway pressure (CPAP) settings on heart and lung function in patients with severe obesity after anesthesia. The main questions it aims to answer are:
1. Does a recruitment maneuver and CPAP set to intrathoracic pressure (ITP) improve cardiopulmonary function compared to standard CPAP settings in patients with severe obesity after anesthesia? 2. Does the location of adipose tissue influence the response to CPAP settings in patients with severe obesity after anesthesia?
Participants will undergo monitoring of their intrathoracic pressure using an esophageal catheter. In the recovery area after anesthesia, participants will receive two CPAP settings, each for 20 minutes.
* Intervention 1: Recruitment maneuver and CPAP will set to the level of intrathoracic pressure * Intervention 2: CPAP set to home settings (if OSA is present) or between 8-10 cmH20 (if OSA is not present).
Adult patients (≥ 18 years old) scheduled for elective non-cardiothoracic surgery requiring general anesthesia with an endotracheal tube
Planned admission to the post-anesthesia care unit (PACU) after surgery
BMI ≥ 40 kg/m2
Receiving ≤ 6 liters of supplemental nasal cannula oxygen
Pregnancy, suspected pregnancy or less than six weeks postpartum Known or current pneumothorax
systolic blood pressure <90 mmHg or >180 mmHg
mean blood pressure <60 or >130 mmHg
Any use of intravenous vasoactive agent