Tracheostomy and Obesity (original) (raw)

Tracheostomy, 2017

Abstract

Obesity is a major worldwide health problem because it is strongly associated with insulin resistance, type 2 diabetes, atherosclerosis, and ischemic heart disease—conditions that are associated with reduced life expectancy and impressive economic and societal consequences. The impact of obesity in the critically ill patient may vary by the type of critical illness, obesity severity (obesity distribution), and obesity associated comorbidities. Obese patients in the intensive care unit are at higher risk for acute cardiovascular complications (congestive heart failure, atrial fibrillation), pulmonary complications (respiratory failure), and renal complications (acute kidney injury). Obesity also represents a challenge in the management of invasive mechanical ventilation, hemodynamic monitoring, and pharmacokinetic dose adjustments. Sometimes this particular patient group may need tracheostomy. This surgical procedure is capable of saving lives. However, in obese patients, some care regarding the position to perform the procedure and cannula selection, for example, can minimize complications. Unfortunately, clinical investigations addressing the care of tracheostomy in obese patients are scare.

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