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2026, Number 4

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Med Crit 2026; 40 (4)

Approach to patients with obesity undergoing bariatric surgery in the intensive care unit

Guerrero GMA, Ortiz GJE, Pérez NOR, Escarramán MD, Minutti PM, Antolínez MJM, Solís PGA, Flores CJC, Rodríguez GI, Zúñiga GCH

Language: Spanish
References: 58
Page: 326-332
PDF size: 918.38 Kb.


ABSTRACT

Introduction: Mexico has one of the highest prevalences of overweight and obesity worldwide, affecting approximately 35-40% of the population. Bariatric surgery has emerged as an effective therapeutic option for the management of morbid obesity and its associated comorbidities; however, it is not exempt from perioperative risks. It has been reported that nearly 10% of patients are readmitted within the first 90 days after surgery, and approximately half of these require admission to the Intensive Care Unit (ICU). Despite these figures, a subgroup of patients remains whose risk is not adequately identified through currently available predictive scoring systems, leading to an underestimation of the true need for critical care admission. Implementing accurate risk stratification strategies would enable timely admission to the ICU, with the potential to significantly reduce postoperative complications, decrease morbidity and mortality, and optimize hospital length of stay as well as the utilization of healthcare resources. Material and methods: a systematic literature search was conducted in June 2025 using MeSH terms in Medline, Cochrane, and LILACS databases. No language or publication date restrictions were applied. Studies addressing bariatric surgery in populations admitted to the Intensive Care Unit (ICU) were included, while other study designs, different populations, and duplicate records were excluded. Conclusions: patients with obesity undergoing bariatric surgery represent a significant clinical challenge due to the physiological impact of laparoscopic surgery and the obesity-related physiological alterations. In addition, these patients are at increased risk of perioperative complications, including bleeding, pulmonary thromboembolism, and postoperative pulmonary complications, all of which may significantly increase morbidity and mortality.


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