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Worldwide, currently more than 1.9 billion adults are overweight, 650 million of them are obese. Hereby they pose a significant burden on the budget of the health system and on the workload of intensive care units. Mechanical ventilation of critically ill obese patients needs to take into account the characteristic pathologic alterations of their respiratory system. Setting the respirator also requires careful consideration. Cornerstones include judicious preoxygenation, selection of a tidal volume of 6 - 8 ml/kg ideal body weight, a level of positive end-expiratory pressure titrated to compensate for the reduced functional residual capacity and concurrently protect the lung from ventilator associated lung injury. In selected cases recruitment manoeuvres may be required. In light of the recently published ART study that showed an increased mortality and higher incidence of pneumothorax and barotrauma, these need to be performed carefully. Correctly positioning the critical obese is an unrenounceable asset of intensive care. Prone position in mechanically ventilated obese ARDS-patients has been proven to be life-saving. However, specifically the supine position and the Trendelenburg position need to consequently be avoided. Failure to do so may result in obesity supine death syndrome. Finally, latest research documented lower mortality rates in obese individuals who require intensive care. This represents another hard to explain obesity paradox.
This article was published in the following journal.
Name: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
The right of the patient or the patient's representative to make decisions with regard to the patient's dying.
A condition in which certain opposing teeth fail to establish occlusal contact when the jaws are closed.
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Pulmonary relating to or associated with the lungs eg Asthma, chronic bronchitis, emphysema, COPD, Cystic Fibrosis, Influenza, Lung Cancer, Pneumonia, Pulmonary Arterial Hypertension, Sleep Disorders etc Follow and track Lung Cancer News ...