Obesity in critical care.
OBJECTIVE
To review literature germane to the care of critically ill obese patients with emphasis upon the pathophysiology of obesity and its impact on clinical management.


RESULTS
Obesity continues to be a health epidemic of the industrialized world, and is associated with substantial morbidity and mortality. Chronic obesity results in derangements in cardiovascular, respiratory and metabolic function. Drug administration may be effected depending on the lipophilicity of the molecule administered. The ability to gain vascular access is often impaired because of large body habitus and should be aided with ultrasound guidance. The fidelity of blood pressure monitoring can also be adversely affected, necessitating the use of direct intraarterial monitoring.


CONCLUSIONS
Obesity has pathophysiologic effects upon all major organ systems. A thorough knowledge of these effects and specific intensive care unit-related issues are necessary for clinicians to anticipate common complications and provide timely and effective treatment for the obese intensive care unit patient.
Joffe
Aaron
A
The Trauma and Life Support Center, University of Wisconsin Hospital and Clinics, Section of Pulmonary and Critical Care Medicine, Madison, WI 53792, USA.
Wood
Ken
K
D000777:Anesthetics / Q000493:pharmacokinetics; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D009747:Nutritional Physiological Phenomena; D009765:Obesity / Q000150:complications*; D020246:Venous Thrombosis / Q000517:prevention & control
D000777:Anesthetics