Aaron Joffe1, Ken Wood. 1. The Trauma and Life Support Center, University of Wisconsin Hospital and Clinics, Section of Pulmonary and Critical Care Medicine, Madison, WI 53792, USA.
Abstract
PURPOSE OF REVIEW: To review literature germane to the care of critically ill obese patients with emphasis upon the pathophysiology of obesity and its impact on clinical management. RECENT FINDINGS: Obesity continues to be a health epidemic of the industrialized world, and is associated with substantial morbidity and mortality. Chronic obesity results in derangements in cardiovascular, respiratory and metabolic function. Drug administration may be effected depending on the lipophilicity of the molecule administered. The ability to gain vascular access is often impaired because of large body habitus and should be aided with ultrasound guidance. The fidelity of blood pressure monitoring can also be adversely affected, necessitating the use of direct intraarterial monitoring. SUMMARY: Obesity has pathophysiologic effects upon all major organ systems. A thorough knowledge of these effects and specific intensive care unit-related issues are necessary for clinicians to anticipate common complications and provide timely and effective treatment for the obese intensive care unit patient.
PURPOSE OF REVIEW: To review literature germane to the care of critically ill obesepatients with emphasis upon the pathophysiology of obesity and its impact on clinical management. RECENT FINDINGS:Obesity continues to be a health epidemic of the industrialized world, and is associated with substantial morbidity and mortality. Chronic obesity results in derangements in cardiovascular, respiratory and metabolic function. Drug administration may be effected depending on the lipophilicity of the molecule administered. The ability to gain vascular access is often impaired because of large body habitus and should be aided with ultrasound guidance. The fidelity of blood pressure monitoring can also be adversely affected, necessitating the use of direct intraarterial monitoring. SUMMARY:Obesity has pathophysiologic effects upon all major organ systems. A thorough knowledge of these effects and specific intensive care unit-related issues are necessary for clinicians to anticipate common complications and provide timely and effective treatment for the obese intensive care unit patient.
Authors: Monisha A Kumar; Rishi Chanderraj; Ryan Gant; Christi Butler; Suzanne Frangos; Eileen Maloney-Wilensky; Jennifer Faerber; W Andrew Kofke; Joshua M Levine; Peter LeRoux Journal: Neurocrit Care Date: 2012-04 Impact factor: 3.210