Fatties and anesthesia

So I don't do anesthesia much on really really big people....I know that is standard for many of you. But I have a question for those that do. I did a laprscopic case (weight loss surgery) yesterday. BMI 53. The patient was persistently hypoxia (84 to 89%) which I am 99% sure the shunting was from decreased FRC and atelecasis. I know this because I was stressed at the beginning - confirmed tube placement above carina, ruled out pneumo with ultrasound, and the kicker was when we put... Fatties and anesthesia
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