How do i manage the morbidly obese critically ill patient?

The prevalence of obesity continues to rise in both the developed and developing countries and is associated with an increased incidence of a wide spectrum of medical and surgical ailments. This chapter provides an overview of the physiologic changes reported in respiratory and metabolic systems and the clinical implications for the management of respiratory failure and circulatory derangements. Alterations in pharmacokinetics and pharmacodynamics often require adjustment in dosing for common therapeutic agents. Proper equipment may be needed to ensure adequate and safe provision of care. Prior to ordering a diagnostic imaging, a review of scanner specification is recommended. Despite higher morbidity associated with the critically ill obese, a paradoxical lower intensive care unit (ICU) mortality (“obesity paradox”) is demonstrated in comparison to nonobese ICU patients.