Search: onr:"swepub:oai:DiVA.org:uu-425765" >
How to ventilate ob...
How to ventilate obese patients in the ICU.
-
De Jong, Audrey (author)
-
Wrigge, Hermann (author)
-
- Hedenstierna, Göran, 1941- (author)
- Uppsala universitet,Klinisk fysiologi,Hedenstiernalaboratoriet
-
show more...
-
Gattinoni, Luciano (author)
-
Chiumello, Davide (author)
-
Frat, Jean-Pierre (author)
-
Ball, Lorenzo (author)
-
Schetz, Miet (author)
-
Pickkers, Peter (author)
-
Jaber, Samir (author)
-
show less...
-
(creator_code:org_t)
- 2020-10-23
- 2020
- English.
-
In: Intensive Care Medicine. - : Springer Nature. - 0342-4642 .- 1432-1238. ; 46:12, s. 2423-2435
- Related links:
-
https://doi.org/10.1...
-
show more...
-
https://link.springe...
-
https://urn.kb.se/re...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Obesity is an important risk factor for major complications, morbidity and mortality related to intubation procedures and ventilation in the intensive care unit (ICU). The fall in functional residual capacity promotes airway closure and atelectasis formation. This narrative review presents the impact of obesity on the respiratory system and the key points to optimize airway management, noninvasive and invasive mechanical ventilation in ICU patients with obesity. Non-invasive strategies should first optimize body position with reverse Trendelenburg position or sitting position. Noninvasive ventilation (NIV) is considered as the first-line therapy in patients with obesity having a postoperative acute respiratory failure. Positive pressure pre-oxygenation before the intubation procedure is the method of reference. The use of videolaryngoscopy has to be considered by adequately trained intensivists, especially in patients with several risk factors. Regarding mechanical ventilation in patients with and without acute respiratory distress syndrome (ARDS), low tidal volume (6 ml/kg of predicted body weight) and moderate to high positive end-expiratory pressure (PEEP), with careful recruitment maneuver in selected patients, are advised. Prone positioning is a therapeutic choice in severe ARDS patients with obesity. Prophylactic NIV should be considered after extubation to prevent re-intubation. If obesity increases mortality and risk of ICU admission in the overall population, the impact of obesity on ICU mortality is less clear and several confounding factors have to be taken into account regarding the "obesity ICU paradox".
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- ARDS
- COVID-19
- HFNC
- Mechanical ventilation
- NIV
- Obese
- Obesity
- Prone position
- Prone positioning
- Anestesiologi och intensivvård
- Anaesthesiology and Intensive Care
- Fysiologi
- Physiology
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
De Jong, Audrey
-
Wrigge, Hermann
-
Hedenstierna, Gö ...
-
Gattinoni, Lucia ...
-
Chiumello, David ...
-
Frat, Jean-Pierr ...
-
show more...
-
Ball, Lorenzo
-
Schetz, Miet
-
Pickkers, Peter
-
Jaber, Samir
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Anesthesiology a ...
- Articles in the publication
-
Intensive Care M ...
- By the university
-
Uppsala University