title: Obesity and ARDS.
abstract: Obesity prevalence continues to increase globally, with figures exceeding 30% of some populations. Patients who are obese experience alterations in baseline pulmonary mechanics, including airflow obstruction, decreased lung volumes, and impaired gas exchange. These physiologic changes have implications in many diseases, including ARDS. The unique physiology of patients who are obese affects the presentation and pathophysiology of ARDS, and patients who are obese who have respiratory failure present specific management challenges. Although more study is forthcoming, ventilator strategies that focus on transpulmonary pressure as a measure of lung stress show promise in pilot studies. Given the increasing prevalence of obesity and the variable effects of obesity on respiratory mechanics and ARDS pathophysiology, we recommend an individualized approach to the management of the obese patient with ARDS.
authors.affiliation: Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA. Electronic address: kahibbert@partners.org.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hibbert
authors.affiliation: Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA.
authors.forename: Mary
authors.initials: M
authors.lastname: Rice
authors.affiliation: Divisions of Pulmonary, Sleep, and Critical Care, Brigham and Women's Hospital, Boston, MA.
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D015897:Comorbidity; D019468:Disease Management; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D015656:Respiratory Mechanics / Q000502:physiology; D012307:Risk Factors