Full Description
This book is the first to describe a practical evidence-based approach to the management of critically ill obese patients with various medical or postoperative respiratory problems in the intensive care unit. In brief, the book aims to identify the best strategy and present clinical recommendations for different circumstances, to establish indications for and contraindications to noninvasive and invasive mechanical ventilation, and to offer clear guidance on weaning from mechanical ventilation and on respiratory care. Causes of acute respiratory failure in the obese patient are discussed, and advice is offered on the prevention and management of complications during mechanical ventilation and on moving and feeding critically ill obese patients. Long-term outcomes, ethical issues, and health care costs are also addressed. The multidisciplinary approach, with contributions from international experts in different specialties, ensures that the book will be of interest to a range of healthprofessionals involved in critical care, including intensivists, anesthesiologists, and pulmonologists.
Contents
Part I. Effects of obesity on respiratory physiology.- Effects of obesity on control of breathing.- Effects of obesity on respiratory mechanics and gas exchange.- Effects of obesity on sleep-disordered breathing.- Implications for mechanical ventilation.- Part II. Causes of acute respiratory failure in the obese patient.- Atelectasis.- Acute respiratory distress syndrome.- Community-acquired pneumonia.- Congestive heart failure.- Abdominal compartment syndrome.- Trauma.- Sleep-disordered breathing.- Drugs and medications.- Part III. Invasive mechanical ventilation in the critically ill obese patient.- Pre-oxygenation before intubation.- Difficult airway management.- Analgesia of the obese patient.- Sedation of the obese patient: indications, management, and complications.- Use of paralytics.- Positioning of the patient for mechanical ventilation.- Prevention of lung derecruitment.- Management of complications associated with mechanical ventilation.- Management of ventilator-inducedlung injury.- Management of the obese pregnant patient.- Modes of ventilation.- Weaning from mechanical ventilation.- Tracheostomy: indications and technique.- Decannulation process in the tracheostomised obese patient.- Part IV. Noninvasive ventilation and oxygen delivery in the critically ill obese patient.- The choice of interface.- The choice of ventilator and ventilator setting.- NIV in type 1 (hypoxemic) acute respiratory failure.- High-flow oxygen via nasal cannula.- NIV in type 2 (hypercapnic) acute respiratory failure.- Prevention of post-extubation respiratory failure.- NIV in the obese patient after surgery.- Determinants of NIV success or failure.- Chronic ventilation in obese patients.- Part V. Moving and feeding the critically ill obese patient.- Transportation of obese patients under mechanical ventilation.- Nutritional support in the critically ill obese ventilated patient.- Rehabilitation of obese patients under mechanical ventilation.- Part VI. Ethical issues, outcomeand costs.- Ethical issues regarding mechanical ventilation.- Long-term outcomes after mechanical ventilation.- Healthcare costs.
