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2023, Number 4

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Med Crit 2023; 37 (4)

Monitoring of mechanical ventilation in obese patients: a weighty task

Sánchez SJC, Alvarado EA, Cárdenas HJV, Solís EDA

Language: Spanish
References: 28
Page: 348-355
PDF size: 250.14 Kb.


ABSTRACT

The number of obese patients admitted to an Intensive Care Unit is increasing every day, most of them requiring mechanical ventilation support. In order to watch out for the consequences that mechanical ventilation builds upon them, we need several tools to allow us monitoring the expected changes in the critically ill patient, due to either natural history of disease or as a result of medical management. The next work will show in detail the modifications of respiratory physiology in the obese patient, several cues when programming mechanical ventilation support and the monitoring that must be carried out.


REFERENCES

  1. Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J [Internet]. 2006;13(4):203-210. Available in: https://www.hindawi.com/journals/crj/2006/834786/

  2. West JB, Luks AM. West's respiratory physiology: the essentials. Philadelphia: Lippincott & Williams & Wilkins; 2016. pp. 146-250.

  3. Hall JE, Hall ME. Guyton and hall textbook of medical physiology E-Book. Amsterdam, Netherlands: Elsevier Health Sciences; 2020. Available in: https://books.google.co.id/books?id=H1rrDwAAQBAJ

  4. Steier J, Lunt A, Hart N, Polkey MI, Moxham J. Observational study of the effect of obesity on lung volumes. Thorax [Internet]. 2014;69(8):752-759. Available in: https://pubmed.ncbi.nlm.nih.gov/24736287/

  5. Yuan H, Schwab RJ, Kim C, He J, Shults J, Bradford R, et al. Relationship between body fat distribution and upper airway dynamic function during sleep in adolescents. Sleep [Internet]. 2013;36(8):1199-1207. Available in: https://pubmed.ncbi.nlm.nih.gov/23904680/

  6. Mandal S, Suh ES, Boleat E, Asher W, Kamalanathan M, Lee K, et al. A cohort study to identify simple clinical tests for chronic respiratory failure in obese patients with sleep-disordered breathing. BMJ Open Respir Res [Internet]. 2014;1(1):e000022. Available in: https://pubmed.ncbi.nlm.nih.gov/25478174/

  7. Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol [Internet]. 2010;108(1):206-211. Available in: https://pubmed.ncbi.nlm.nih.gov/19875713/

  8. Powers MA. The obesity hypoventilation syndrome. Respir Care [Internet]. 2008;53(12):1723-1730. Available in: https://rc.rcjournal.com/content/53/12/1723

  9. Martino JL, Stapleton RD, Wang M, Day AG, Cahill NE, Dixon AE, et al. Extreme obesity and outcomes in critically ill patients. Chest [Internet]. 2011;140(5):1198-1206. Available in: https://pubmed.ncbi.nlm.nih.gov/21816911/

  10. Shashaty MGS, Stapleton RD. Physiological and management implications of obesity in critical illness. Ann Am Thorac Soc [Internet]. 2014;11(8):1286-1297. Available in: https://pubmed.ncbi.nlm.nih.gov/25172506/

  11. De Jong A, Wrigge H, Hedenstierna G, Gattinoni L, Chiumello D, Frat JP, et al. How to ventilate obese patients in the ICU. Intensive Care Med. 2020;46(12):2423-2435.

  12. De Jong A, Chanques G, Jaber S. Mechanical ventilation in obese ICU patients: from intubation to extubation. Crit Care. 2017;21(1):63.

  13. Bonatti G, Robba C, Ball L, Silva PL, Rocco PRM, Pelosi P. Controversies when using mechanical ventilation in obese patients with and without acute distress respiratory syndrome. Expert Rev Respir Med. 2019;13(5):471-479.

  14. Grassi L, Kacmarek R, Berra L. Ventilatory mechanics in the patient with obesity. Anesthesiology. 2020;132(5):1246-1256.

  15. Ball L, Pelosi P. How I ventilate an obese patient. Crit Care [Internet]. 2019;23(1):1-3. Available in: https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2466-x

  16. Schetz M, De Jong A, Deane AM, Druml W, Hemelaar P, Pelosi P, et al. Obesity in the critically ill: a narrative review. Intensive Care Med. 2019;45(6):757-769.

  17. Pelosi P, Gregoretti C. Perioperative management of obese patients. Best Pract Res Clin Anaesthesiol. 2010;24(2):211-225.

  18. Futier E, Constantin JM, Pelosi P, Chanques G, Massone A, Petit A, et al. Noninvasive ventilation and alveolar recruitment maneuver improve respiratory function during and after intubation of morbidly obese patients: a randomized controlled study. Anesthesiology [Internet]. 2011;114(6):1354-1363. Available in: https://pubmed.ncbi.nlm.nih.gov/21478734/

  19. Falcao LFDR, Pelosi P, De Abreu MG. Protective mechanical ventilation in the obese patient. Int Anesthesiol Clin [Internet]. 2020;58(3):53-57. Available in: https://journals.lww.com/anesthesiaclinics/Fulltext/2020/05830/Protective_mechanical_ventilation_in_the_obese.9.aspx

  20. Pépin JL, Borel JC, Janssens JP. Obesity hypoventilation syndrome: an underdiagnosed and undertreated condition. Am J Respir Crit Care Med [Internet]. 2013;186(12):1205-1207. Available in: https://doi.org/101164/rccm201210-1922ED

  21. Pankow W, Podszus T, Gutheil T, Penzel T, Peter JH, von Wichert P. Expiratory flow limitation and intrinsic positive end-expiratory pressure in obesity. J Appl Physiol. 1998;85(4):1236-1243.

  22. Magder S, Slobod D, Assanangkornchai N. Mechanical ventilation in the obese patient: compliance, pleural pressure, and driving pressure. Am J Respir Crit Care Med [Internet]. 2021;203(5):534-536. Available in: www.icnarc.org/DataServices/Attachments/Download/7673eac0-

  23. Esquinas AM, Lemyze M. Mechanical ventilation in the critically ill obese patient. Mechanical Ventilation in the Critically Ill Obese Patient. Springer; 2018. pp. 1-315.

  24. Ball L, Hemmes SNT, Serpa Neto A, Bluth T, Canet J, Hiesmayr M, et al. Intraoperative ventilation settings and their associations with postoperative pulmonary complications in obese patients. Br J Anaesth. 2018;121(4):899-908.

  25. Pereira SM, Tucci MR, Morais CCA, Simoes CM, Tonelotto BFF, Pompeo MS, et al. Individual positive end-expiratory pressure settings optimize intraoperative mechanical ventilation and reduce postoperative atelectasis. Anesthesiology. 2018;129(6):1070-1081.

  26. Fumagalli J, Santiago RRS, Teggia Droghi M, Zhang C, Fintelmann FJ, Troschel FM, et al. Lung recruitment in obese patients with acute respiratory distress syndrome. Anesthesiology. 2019;130(5):791-803.

  27. Mahul M, Jung B, Galia F, Molinari N, de Jong A, Coisel Y, et al. Spontaneous breathing trial and post-extubation work of breathing in morbidly obese critically ill patients. Crit Care [Internet]. 2016;20(1):346. Available in: https://pubmed.ncbi.nlm.nih.gov/27784322/

  28. Obi ON, Mazer M, Bangley C, Kassabo Z, Saadah K, Trainor W, et al. Obesity and weaning from mechanical ventilation-an exploratory study. Clin Med Insights Circ Respir Pulm Med [Internet]. 2018;12:1179548418801004. Available in: http://www.ncbi.nlm.nih.gov/pubmed/30245572




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