title: Obesity: physiologic changes and implications for preoperative management.
abstract: The proportion of patients defined as obese continues to grow in many westernized nations, particularly the United States (USA). This trend has shifted the perioperative management of obese patients into the realm of routine care. As obese patients present for all types of procedures, it is crucial for anesthesiologists, surgeons, internists, and perioperative health care providers alike to have a firm understanding of their altered multi-organ physiology in order to safely prepare the obese patient for an operation. A careful preoperative evaluation may also serve to identify risk factors for postoperative adverse events. Subsequently, preoperative measures may be implemented to mitigate these complications. In this manuscript we address the major considerations for the preoperative evaluation of the severely obese patient.
authors.affiliation: Department of Anesthesia, Critical Care & Pain Medicine, Associate Anesthetist, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. vortiz@mgh.harvard.edu.
authors.forename: Vilma E
authors.initials: VE
authors.lastname: Ortiz
authors.affiliation: Department of Anesthesia, Critical Care & Pain Medicine, Associate Anesthetist, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. jkwo@mgh.harvard.edu.
authors.forename: Jean
authors.initials: J
authors.lastname: Kwo
mesh_terms: D006801:Humans; D009765:Obesity / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods