title: Management of obese patients with respiratory failure - A practical approach to a health care issue of increasing significance.
abstract: In the general population, prevalence of obesity is increasing continuously. Concomitantly, a growing number of obese patients with severe illnesses presents at intensive care units (ICU). Particularly respiratory management of this patient group poses a challenge to intensive care physicians because of differences in respiratory anatomy and physiology in obese compared to non-obese individuals. Aim of this review is to present treatment options for critically ill obese patients requiring mechanical ventilation based on current studies concerning patient positioning, ventilatory regimen as well as extended therapy with veno-venous extracorporeal membrane oxygenation (ECMO). The ideal concept for respiratory management depends on multiple aspects and has to be determined individually. Knowledge of altered respiratory anatomy and physiology in obese patients and possible treatment options may facilitate respiratory management in this patient group.
authors: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany. Electronic address: Alicia.fischer@ukmuenster.de.
authors: Alicia Jeanette
authors: AJ
authors: Fischer
authors: Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors: Sven
authors: S
authors: Kaese
authors: Division of Cardiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany.
authors: Pia
authors: P
authors: Lebiedz
mesh_terms: D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy; D003695:Delivery of Health Care / Q000592:standards*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D056888:Patient Positioning / Q000379:methods; D015995:Prevalence; D012121:Respiration, Artificial / Q000379:methods; D012129:Respiratory Function Tests / Q000379:methods; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D016896:Treatment Outcome
keywords: Extracorporeal membrane oxygenation; Intensive care; Mechanical ventilation; Obesity; Positioning; Respiratory management