Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Dedication
- Section 1 General aspects
- Section 2 Pathophysiology
- Section 3 Pre-operative management
- Section 4 Peri-operative management of co-morbidities
- Section 5 Pharmacology
- Section 6 Monitoring
- Section 7 Intra-operative management
- Section 8 Post-operative care
- 25 Post-anesthetic care unit management
- 26 Respiratory management
- 27 Management of the obese critically ill patient in intensive care unit
- 28 Nursing management
- 29 Post-operative analgesia
- Section 9 Conclusions
- Afterword
- Index
27 - Management of the obese critically ill patient in intensive care unit
from Section 8 - Post-operative care
Published online by Cambridge University Press: 17 August 2009
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Dedication
- Section 1 General aspects
- Section 2 Pathophysiology
- Section 3 Pre-operative management
- Section 4 Peri-operative management of co-morbidities
- Section 5 Pharmacology
- Section 6 Monitoring
- Section 7 Intra-operative management
- Section 8 Post-operative care
- 25 Post-anesthetic care unit management
- 26 Respiratory management
- 27 Management of the obese critically ill patient in intensive care unit
- 28 Nursing management
- 29 Post-operative analgesia
- Section 9 Conclusions
- Afterword
- Index
Summary
Introduction
Obesity has reached epidemic levels in the US, affecting >30% of adults. The health care costs associated with obesity is estimated to be 4.3% of the total US health care costs. This roughly translates into expenditures over $51.6 billion. With the increasing prevalence of obesity in the general population, it is not surprising that many obese patients are treated in intensive care settings. The critically ill obese patient presents the critical care team with many unique problems.
The impact of obesity on outcome in critically ill patients has not been well studied. There are only few comprehensive reviews that detail the management of the obese critically ill patient. Obesity was not included as a co-morbid variable in the development of the APACHE II and III or SAPS prognostic indices for critically ill patients. Smith-Choban and colleagues, reported that morbidly obese patients have a 8-fold higher mortality following blunt trauma than non-obese patients. A retrospective review of 117 patients with body mass index (BMI) > 40 admitted to a medical intensive care unit (ICU) over a 6-year span revealed significant increases in ICU stay, mortality and length of mechanical ventilation. In this study the APACHE II scores were not significantly different between obese and non-obese patients. Furthermore, it has been shown that hospitalized obese patients are at an increased risk of developing respiratory and other complications.
- Type
- Chapter
- Information
- Morbid ObesityPeri-Operative Management, pp. 363 - 370Publisher: Cambridge University PressPrint publication year: 2004