Book contents
- Core Topics in Anaesthesia and Peri-operative Care of the Morbidly Obese Surgical Patient
- Core Topics in Anaesthesia and Peri-operative Care of the Morbidly Obese Surgical Patient
- Copyright page
- Contents
- Contributors
- Preface
- Abbreviations
- Section 1 Background to Obesity, Epidemiology and Anthropology
- Section 2 Pathophysiology of Obesity
- Section 3 Pre-operative Assessment and Preparation
- Section 4 Intra-operative Management
- Section 5 Post-operative Care
- Section 6 Bariatric Surgery
- Index
- References
Section 2 - Pathophysiology of Obesity
Published online by Cambridge University Press: 24 September 2018
Book contents
- Core Topics in Anaesthesia and Peri-operative Care of the Morbidly Obese Surgical Patient
- Core Topics in Anaesthesia and Peri-operative Care of the Morbidly Obese Surgical Patient
- Copyright page
- Contents
- Contributors
- Preface
- Abbreviations
- Section 1 Background to Obesity, Epidemiology and Anthropology
- Section 2 Pathophysiology of Obesity
- Section 3 Pre-operative Assessment and Preparation
- Section 4 Intra-operative Management
- Section 5 Post-operative Care
- Section 6 Bariatric Surgery
- Index
- References
- Type
- Chapter
- Information
- Core Topics in Anaesthesia and Peri-operative Care of the Morbidly Obese Surgical Patient , pp. 29 - 58Publisher: Cambridge University PressPrint publication year: 2018
References
Further Reading
Alpert, MA, Terry, BE, Cohen, MV, et al. The electrocardiogram in morbid obesity. Am J Cardiol. 2000;85(7):908–10.CrossRefGoogle ScholarPubMed
Anand, RG, Peters, RW, Donahue, TP Obesity and dysrhythmias. J Cardiometab Syndr. 2008;3:149–54.CrossRefGoogle ScholarPubMed
Bernick, S, Davis, CB The Economic Cost of Cardiovascular Disease from 2014–2020 in Six European Countries. London: Centre for Economic and Business Research; 2014.Google Scholar
Cole, VW, Alexander, JK Clinical effects of extreme obesity on cardiopulmonary function. South Med J. 1959;52(4):435–8.Google Scholar
Curtis, JP, Selter, JG, Wang, Y, et al. The obesity paradox: body mass index and outcomes in patients with heart failure. Arch Intern Med. 2005;165:55–61.CrossRefGoogle ScholarPubMed
Duflou, J, Virmani, R, Rabin, I, et al. Sudden death as a result of heart disease in morbid obesity. Am Heart J. 1995;130(2):306–13.CrossRefGoogle ScholarPubMed
Frank, S, Colliver, JA, Frank, A. The electrocardiogram in obesity: statistical analysis of 1,029 patients. J Am Coll Cardiol. 1996;7(2):295–9.Google Scholar
Goncalves, IE, Rocha, M, et al. Echocardiography evaluations for asymptomatic patients with severe obesity. Arq Bras Cardiol. 2007;88(1):48–53.Google Scholar
Gruberg, L, Weissman, NJ, Waksman, R, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary interven- tion: the obesity paradox? J Am Coll Cardiol. 2002;39:578–84.CrossRefGoogle Scholar
Larsen, OA, Lassen, NA, Quaade, F. Blood flow through human adipose tissue determined with radioactive xenon. Acta Physiol Scand. 1996;66(3):337–45.Google Scholar
Martin, SS, Qasim, A, Reilly, MP Leptin resistance a possible interface of inflammation and metabolism in obesity-related cardiovascular disease. J Am Coll Cardiol. 2008;52:1201–10.Google Scholar
Messerli, FH, Nunez, BD, Ventura, HO, et al. Overweight and sudden death. Increased ventricular ectopy in cardiopathy of obesity. Arch Intern Med. 1987;147(10):1725–8.Google Scholar
Mullen, J, Moorman, D, Davenport, D. The obesity paradox: body mass index and outcomes in patients undergoing non-bariatric general surgery. Ann Surg. 2009;250(1):166–72.Google Scholar
Rimm, EB, Stampfer, MJ, Giovannucci, E, et al. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol. 1995;141:1117–27.CrossRefGoogle ScholarPubMed
Seyfeli, E, Duru, M, Kuvandick, G, et al. Effect of obesity on P-wave dispersion and QT dispersion in women. Int J Obes. 2006;30(6):957–61.Google Scholar
Smith, HL, Willius, FA Adiposity of the heart: a clinical and pathologic study of 136 obese patients. Arch Intern Med. 1933;52:910–39.Google Scholar
Stelfox, HT, Ahmed, SB, Ribeiro, RA, et al. Haemodynamic monitoring in obese patients: the impact of body mass index on cardiac output and stroke volume. Crit Care Med. 2006;34(4):1243–6.Google Scholar
Thomas, F, Bean, K, Pannier, B, et al. Cardiovascular mortality in overweight subjects: the key role of associated risk factors. Hypertension. 2005;46:654–9.Google Scholar
Townsend, N, Williams, J, Bhatnagar, P, et al. Cardiovascular Disease Statistics. London: British Heart Foundation; 2014.Google Scholar
Uretsky, S, Messerli, FH, Bangalore, S, et al. Obesity paradox in patients with hypertension and coronary artery disease. Am J Med. 2007;120:863–870.CrossRefGoogle ScholarPubMed
Wang, TJ, Parise, H, Levy, D, et al. Obesity and the risk of new-onset atrial fibrillation. J Am Med Assoc. 2004;292(20):2471–7.Google Scholar
Further Reading
Behazin, N, Jones, SB, Cohen, RI, et al. Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity. J Appl Physiol. 2010;108(1):212–18.CrossRefGoogle ScholarPubMed
Holley, HS, Milic-Emili, J, Becklake, MR, et al. Regional distribution of pulmonary ventilation and perfusion in obesity. J Clin Invest. 1967;46:475–81.CrossRefGoogle ScholarPubMed
Jones, Rl, Nzekwu, MM. The effects of body mass index on lung volumes. Chest. 2006;130(3):827–33.CrossRefGoogle ScholarPubMed
Naimark, A, Cherniack, RM. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol. 1960;15(3):377–82.Google Scholar
Nicolacakis, K, Skowronski, ME, Coreno, AJ, et al. Observations on the physiological interactions between obesity and asthma. J Appl Physiol. 2008;105(5):1533–41.Google Scholar
Pelosi, P, Croci, M, Ravagnan, I, et al. The effects of body mass on lung volumes, respiratory mechanics and gas exchange during general anaesthesia. Anaesth Analg. 1998;87(3):654–60.Google Scholar
Salome, CM, King, GG, Berend, N. Physiology of obesity and effects on lung function. J Appl Physiol. 2010;108(1):206–11.Google Scholar
Stanchina, ML, Malhotra, A, Fogel, RB, et al. The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleep. Sleep. 2003;26(7):851–6.Google Scholar
Sutherland, TJ, Cowan, JO, Young, S, et al. The association between obesity and asthma: interactions between systemic and airway inflammation. Am J Respir Crit Care Med. 2008;1789(5):469–75.Google Scholar
Tagaito, Y, Isono, S, Remmers, JE, et al. Lung volume and collapsibility of the passive pharynx in patients with sleep-disordered breathing. J Appl Physiol. 2007;103(4):1379–85.CrossRefGoogle ScholarPubMed
Further Reading
American Society of Anesthesiologists. Practice guidelines for the perioperative management of patients with obstructive sleep apnea. Anesthesiology. 2014;120(2):268–86.Google Scholar
Downey, R. Obstructive sleep apnea. 2017. http://emedicine.medscape.com/article/295807-overview (accessed April 2018).Google Scholar
Mokhlesi, B. Obesity hypoventilation syndrome: a state-of-the-art review. Respir Care. 2010;55(10):1347–65.Google Scholar
Further Reading
Andreasen, PB, Dano, P, Kirk, H, Greisen, G Drug absorption and hepatic drug metabolism in patients with different types of intestinal shunt operation for obesity: a study with phenazone Scand J Gastroenterol. 1977;5:531–5.Google Scholar
Benedek, IH, Blouin, RA, McNamara, PJ Serum protein binding and the role of increased alpha 1-acid glycoprotein in moderately obese male subjects. Br J Clin Pharmacol. 1984;6:941–6.Google Scholar
Benedek, IH, Fiske, WD 3rd, Griffen, WO, et al. Serum alpha 1-acid glycoprotein and the binding of drugs in obesity. Br J Clin Pharmacol. 1983;6:751–4.Google Scholar
Blouin, RA, Warren, GW Pharmacokinetic considerations in obesity. J Pharm Sci. 1999;1:1–7.Google Scholar
Bowman, SL, Hudson, SA, Simpson, G, Munro, JF, Clements, JA A comparison of the pharmacokinetics of propranolol in obese and normal volunteers Br J Clin Pharmacol. 1986;5:529–32.Google Scholar
Brill, MJ, Diepstraten, J, van Rongen, A, et al. Impact of obesity on drug metabolism and elimination in adults and children Clin Pharmacokinet. 2012;5:277–304.Google Scholar
Brodsky, JB, Lemmens, HJ Anesthetic Management of the Obese Surgical Patient. Cambridge: Cambridge University Press; 2011.Google Scholar
Carron, M, Freo, U, Parotto, E, Ori, C The correct dosing regimen for sugammadex in morbidly obese patients. Anaesthesia. 2012;3:298–9.Google Scholar
Cortinez, LI, Anderson, BJ, Penna, A, et al. Influence of obesity on propofol pharmacokinetics: derivation of a pharmacokinetic model. Br J Anaesth. 2010;4:448–56.Google Scholar
Cortinez, LI, De la Fuente, N, Eleveld, DJ, et al. Performance of propofol target-controlled infusion models in the obese: pharmacokinetic and pharmacodynamic analysis. Anesth Analg. 2014;2:302–10.Google Scholar
Das, SK, Roberts, SB, McCrory, MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;1:22–30.Google Scholar
Ducharme, MP, Slaughter, RL, Edwards, DJ Vancomycin pharmacokinetics in a patient population: effect of age, gender, and body weight. Ther Drug Monit. 1994;5: 513–18.Google Scholar
DuBois, D, DuBois, EF A formula to estimate the approximate surface area if height and weight be known. Arch Int Med. 1916;17:863–71.Google Scholar
Egan, TD, Huizinga, B, Gupta, SK, et al. Remifentanil pharmacokinetics in obese versus lean patients. Anesthesiology. 1998;3:562–73.Google Scholar
Erstad, BL, Patanwala, AE Ketamine for analgosedation in critically ill patients. J Crit Care. 2016:145–149.CrossRefGoogle Scholar
Graves, DA, Batenhorst, RL, Bennett, RL, et al. Morphine requirements using patient-controlled analgesia: influence of diurnal variation and morbid obesity. Clin Pharm. 1983;1:49–53.Google Scholar
Green, B, Duffull, SB What is the best size descriptor to use for pharmacokinetic studies in the obese? Br J Clin Pharmacol. 2004;2:119–33.Google Scholar
Greenblatt, DJ, Abernethy, DR, Locniskar, A, et al. Effect of age, gender, and obesity on midazolam kinetics. Anesthesiology. 1984;1:27–35.Google Scholar
Gurney, H Dose calculation of anticancer drugs: a review of the current practice and introduction of an alternative. J Clin Oncol. 1996;9:2590–611.Google Scholar
Han, PY, Duffull, SB, Kirkpatrick, CM, Green, B Dosing in obesity: a simple solution to a big problem. Clin Pharmacol Ther. 2007;5:505–8.Google Scholar
Ingrande, J, Brodsky, JB, Lemmens, HJ Lean body weight scalar for the anesthetic induction dose of propofol in morbidly obese subjects. Anesth Analg. 2011;1:57–62.CrossRefGoogle Scholar
Ingrande, J, Lemmens, HJ Dose adjustment of anaesthetics in the morbidly obese. Br J Anaesth. 2010:i16–23.Google Scholar
Janmahasatian, S, Duffull, SB, Ash, S et al. Quantification of lean bodyweight. Clin Pharmacokinet. 2005;44:1051–65CrossRefGoogle ScholarPubMed
Juvin, P, Vadam, C, Malek, L, et al. Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: a prospective, randomized study. Anesth Analg. 2000;3:714–19.Google Scholar
Keys, A, Fidanza, F, Karvonen, MJ, Kimura, N, Taylor, HL Indices of relative weight and obesity. J Chronic Dis. 1972;25(6–7):329–43.CrossRefGoogle ScholarPubMed
Kirkegaard-Nielsen, H, Helbo-Hansen, HS, Lindholm, P, Severinsen, IK, Pedersen, HS Anthropometric variables as predictors for duration of action of atracurium-induced neuromuscular block. Anesth Analg. 1996;5:1076–80.Google Scholar
Kyle, UG, Piccoli, A, Pichard, C Body composition measurements: interpretation finally made easy for clinical use. Curr Opin Clin Nutr Metab Care. 2003;4:387–93.Google Scholar
La Colla, L, Albertin, A, La Colla, G, et al. Predictive performance of the ‘Minto’ remifentanil pharmacokinetic parameter set in morbidly obese patients ensuing from a new method for calculating lean body mass. Clin Pharmacokinet. 2010;2:131–9.Google Scholar
Lemmens, HJ, Brodsky, JB The dose of succinylcholine in morbid obesity. Anesth Analg. 2006;2:438–42.Google Scholar
Lemmens, HJ, Brodsky, JB, Bernstein, DP Estimating ideal body weight–a new formula. Obes Surg. 2005;5(7):1082–3.Google Scholar
Lemmens, HJ, Saidman, LJ, Eger, EI, 2nd, Laster, MJ Obesity modestly affects inhaled anesthetic kinetics in humans. Anesth Analg.2008;6:1864–70.Google Scholar
Leykin, Y, Pellis, T, Lucca, M, et al. The pharmacodynamic effects of rocuronium when dosed according to real body weight or ideal body weight in morbidly obese patients. Anesth Analg. 2004;4:1086–9.Google Scholar
Linares, CL, Decleves, X, Oppert, JM, et al. Pharmacology of morphine in obese patients. Clin Pharmacokinet. 2009;10:635–51.Google Scholar
Martinoli, R, Mohamed, EI, Maiolo, C, et al. Total body water estimation using bioelectrical impedance: a meta-analysis of the data available in the literature. Acta Diabetol. 2003:S203–6.Google Scholar
McCarron, MM, Devine, BJ Clinical pharmacy: case studies case number 25 gentamicin therapy. Ann Pharmacother. 1974;11:650–5.Google Scholar
McLeay, SC, Morrish, GA, Kirkpatrick, CM, Green, B The relationship between drug clearance and body size: systematic review and meta-analysis of the literature published from 2000 to 2007. Clin Pharmacokinet. 2012;5:319–30.Google Scholar
Miller, D, Carlson, J, Loyd, B, Day, B Determining ideal body weight (letter). Am J Hosp Pharm. 1983:1622.CrossRefGoogle Scholar
Monk, TG, Rietbergen, H, Woo, T, Fennema, H Use of sugammadex in patients with obesity: a pooled analysis. Am J Thera. 2015;24(5):e507–16.Google Scholar
Moore, FD Energy and the maintenance of the body cell mass. J Parent Ent Nutr. 1980;3:228–60.Google Scholar
Moretto, M, Kupski, C, Mottin, CC, et al. Hepatic steatosis in patients undergoing bariatric surgery and its relationship to body mass index and co-morbidities. Obes Surg. 2003;4:622–4.Google Scholar
Mosteller, RD Simplified calculation of body-surface area. N Engl J Med. 1987;17:1098.Google Scholar
Nightingale, CE, Margarson, MP, Shearer, E, et al. Peri-operative management of the obese surgical patient 2015. Anaesthesia. 2015;7:859–76.Google Scholar
Pai, MP, Paloucek, FP The origin of the ‘ideal’ body weight equations. Ann Pharmacother. 2000:1066–9.Google Scholar
Reiss, RA, Haas, CE, Karki, SD, et al. Lithium pharmacokinetics in the obese. Clin Pharmacol Ther. 1994;4:392–8.Google Scholar
Robinson, JD, Lupkiewicz, SM, Palenik, L, Lopez, LM, Ariet, M. Determination of ideal body weight for drug dosage calculations. Am J Hosp Pharm. 1983;6:1016–19.Google Scholar
Rose, DK, Cohen, MM, Wigglesworth, DF, DeBoer, DP Critical respiratory events in the postanesthesia care unit: patient, surgical, and anesthetic factors. Anesthesiology. 1994;2:410–18.Google Scholar
Sakizci-Uyar, B, Celik, S, Postaci, A, et al. Comparison of the effect of rocuronium dosing based on corrected or lean body weight on rapid sequence induction and neuromuscular blockade duration in obese female patients Saudi Med J. 2016;1:60–5.Google Scholar
Schwartz, AE, Matteo, RS, Ornstein, E, Halevy, JD, Diaz, J Pharmacokinetics and pharmacodynamics of vecuronium in the obese surgical patient. Anesth Analg. 1992;4:515–18.Google Scholar
Servin, F, Farinotti, R, Haberer, JP, Desmonts, JM Propofol infusion for maintenance of anesthesia in morbidly obese patients receiving nitrous oxide: a clinical and pharmacokinetic study. Anesthesiology. 1993;4:657–65.Google Scholar
Sharma, V, McNeill, JH To scale or not to scale: the principles of dose extrapolation Br J Pharmacol. 2009;6:907–21.Google Scholar
Shibutani, K, Inchiosa, MA, Jr, Sawada, K, Bairamian, M Pharmacokinetic mass of fentanyl for postoperative analgesia in lean and obese patients. Br J Anaesth. 2005;3:377–83.Google Scholar
Stokholm, KH, Brochner-Mortensen, J, Hoilund-Carlsen, PFIncreased glomerular filtration rate and adrenocortical function in obese women. Int J Obes. 1980;1:57–63.Google Scholar
Strum, EM, Szenohradszki, J, Kaufman, WA, et al. Emergence and recovery characteristics of desflurane versus sevoflurane in morbidly obese adult surgical patients: a prospective, randomized study. Anesth Analg. 2004;6:1848–53.Google Scholar
Van Lancker, P, Dillemans, B, Bogaert, T, et al. Ideal versus corrected body weight for dosage of sugammadex in morbidly obese patients. Anaesthesia. 2011;8:721–5.Google Scholar
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;9403:157–63.Google Scholar
Further Reading
Alberti, KG, Eckel, RH, Grundy, SM, et al. Harmonizing the metabolic syndrome: a joint interim statement. Circulation. 2009;120(16):1640–5.Google Scholar
Berg, AH, Scherer, PE Adipose tissue, inflammation, and cardiovascular disease. Circul Res. 2005;96(9):939–49.CrossRefGoogle ScholarPubMed
Brownlee, M The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615–25.Google Scholar
Cooper, SA, Whaley-Connell, A, Habibi, J, et al.Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance. Am J Physiol Heart Circul Physiol. 2007;293(4):2009–23.Google Scholar
Dandona, P, Aljada, A, Chaudhuri, A, Mohanty, P, Garg, RMetabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation. 2005;111(11):1448–54.CrossRefGoogle ScholarPubMed
Day, C, Bailey, CJ Obesity in the pathogenesis of type 2 diabetes. Br J Diabetes Vasc Dis. 2011;11(2):55–61.Google Scholar
Després, JP, Lemieux, I Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881–7.Google Scholar
Hajer, GR, van Haeften, TW, Visseren, FL Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959–71.Google Scholar
Kahn, SE, Hull, RL, Utzschneider, KM Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444(7121):840–6.Google Scholar
Kershaw, EE, Flier, JS Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89(6):2548–56.Google Scholar
Petersen, KF, Shulman, GI Etiology of insulin resistance. Am J Med. 2006;119(5 Suppl 1): S10–S16.Google Scholar
Qatanani, M, Lazar, MA Mechanisms of obesity-associated insulin resistance: many choices on the menu. Genes Develop. 2007;21(12):1443–55.Google Scholar
Redinger, RN The pathophysiology of obesity and its clinical manifestations. Gastroenterol Hepatol. 2007;3(11):856–63.Google Scholar
Shoelson, SE, Lee, J, Goldfine, AB Inflammation and insulin resistance. J Clin Invest. 2006;116(7):1793–801.Google Scholar
Unger, RH Lipotoxicity in the pathogenesis of obesity-dependent NIDDM: genetic and clinical implications. Diabetes. 1995;44(8):863–70.Google Scholar