Complications Associated with Invasive Mechanical Ventilation in Obese Patients

2017 ◽  
pp. 151-156
Author(s):  
Nishant Chauhan
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Obese Patients

scholarly journals Outcomes of Morbidly Obese Patients Receiving Invasive Mechanical Ventilation

CHEST Journal ◽  
2013 ◽  
Vol 144 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Gagan Kumar ◽  
Tilottama Majumdar ◽  
Elizabeth R. Jacobs ◽  
Valerie Danesh ◽  
Gaurav Dagar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Morbidly Obese ◽  
Obese Patients

Controlled invasive mechanical ventilation strategies in obese patients undergoing surgery

2017 ◽  
Vol 11 (6) ◽  
pp. 443-452 ◽  
Author(s):  
Lígia de Albuquerque Maia ◽  
Pedro Leme Silva ◽  
Paolo Pelosi ◽  
Patricia Rieken Macedo Rocco
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Obese Patients ◽  
Ventilation Strategies

scholarly journals Relationship between obesity and the occurrence of negative outcome in patients hospitalized with COVID-19: integrative literature review

2021 ◽  
Vol 10 (13) ◽  
pp. e165101321038
Author(s):  
Eline Fernandes Ribeiro de Castro ◽  
Chriscia Jamilly Pinto de Sousa ◽  
Carolina Heitmann Mares Azevedo Ribeiro ◽  
Carlos Augusto Abreu Alberio
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Invasive Mechanical Ventilation ◽  
Severe Form ◽  
National Institutes Of Health ◽  
Obese Patients ◽  
National Library ◽  
The Relationship ◽  
High Bmi

Objective: To verify the relationship between obesity and the occurrence of negative outcomes in hospitalized patients. Methodology: An integrative review was carried out using the National Library of Medicine of the National Institutes of Health (PubMed) and the Virtual Health Library (VLH/BVS) database. Results: It was observed that obese patients are 2 to 5 times more likely to need Invasive Mechanical Ventilation (IMV) when admitted to the Intensive Care Unit. Patients with high BMI (obese) and who needed mechanical ventilation had a mortality rate above 60%. The risk increases as the patient has other pathologies, this fact is shown that mortality by COVID-19 has multifactorial causes. Conclusion: The study showed that obesity is a risk factor associated with the increased development of the severe form of the disease, usually associated with other pathologies (hypertension, diabetes and cardiovascular diseases). That is, obesity increases the likelihood of unfavorable outcomes.

scholarly journals Characterization and Outcomes in Patients with SARS-CoV-2 Infection According to Body Mass Index, Fundación Valle Del Lili, Cali, Colombia 2020-2021

2021 ◽  
Author(s):  
Karen Milena Feriz ◽  
Veline Martínez ◽  
Guillermo Edinson Guzman
Keyword(s):  
Body Mass Index ◽  
Mechanical Ventilation ◽  
Body Mass ◽  
Association Studies ◽  
Invasive Mechanical Ventilation ◽  
Infectious Complications ◽  
University Hospital ◽  
Accelerated Expansion ◽  
Obese Patients ◽  
Prospective Longitudinal

Abstract Introduction: SARS-CoV-2 has undergone an accelerated expansion and was declared a pandemic in 2020. It has been responsible of millions of deaths around the world. Several factors related to severity and mortality have been described, including obesity(1,2). In United States and in Latin America, obesity has grown rapidly (3). In Colombia, 56% of the population is overweight/obese. However, in the region, association studies of SARS-CoV-2 and obesity are scarce. We sought to investigate the characterization and outcomes of patients according to body mass index in a highly complex center in Colombia.Material and Methods: The study was a prospective longitudinal observational descriptive study in patients older than 18 years treated at the Fundación Valle del Lili University Hospital in Cali, Colombia in 2020-2021, with a diagnosis of SARS-CoV-2 infection. Sociodemographic characteristics, medical history, clinical presentation, paraclinical characteristics and outcomes were described. Results: The average age was 48 years, 53% were men, and 66.5% were overweight or obese. Dyspnea (p = 0.003) was the most representative symptom in overweight/obesity. The severity of the disease (p = 0.02), days of stay in the ICU (p = 0.045), overall stay (p = 0.0037), and mechanical ventilation (p = 0) had relationships directly proportional to the increase in BMI (p = 0.022). Obese patients had a higher frequency of sepsis (P 0.003), need for vasopressor (P = 0.001), infectious complications (P = 0.011) and myocarditis (P = 0.03). There was no relationship with thrombotic complications.Conclusion. Overweight and obese patients have more severe symptoms of SARS-CoV-2, infectious complications, and requirements for invasive mechanical ventilation, general hospitalization and ICU stay than the normal weight population.

Ambulatory care of non-invasive mechanical ventilation in COPD patients with global decompensated respiratory acidosis

Pneumologie ◽  
2017 ◽  
Vol 71 (S 01) ◽  
pp. S1-S125
Author(s):  
EJ Soto Hurtado ◽  
P Gutiérrez Castaño ◽  
JJ Torres ◽  
MD Jiménez Fernández ◽  
M Pérez Soriano ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ambulatory Care ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Non Invasive ◽  
Copd Patients

scholarly journals Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
J.-L. Diehl ◽  
N. Peron ◽  
R. Chocron ◽  
B. Debuc ◽  
E. Guerot ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dead Space ◽  
Respiratory Mechanics ◽  
Invasive Mechanical Ventilation ◽  
Endothelial Damage ◽  
Circulating Endothelial Cells ◽  
Pulmonary Mechanics ◽  
High Peep ◽  
Gas Exchanges ◽  
Physiological Dead Space

Abstract Rationale COVID-19 ARDS could differ from typical forms of the syndrome. Objective Pulmonary microvascular injury and thrombosis are increasingly reported as constitutive features of COVID-19 respiratory failure. Our aim was to study pulmonary mechanics and gas exchanges in COVID-2019 ARDS patients studied early after initiating protective invasive mechanical ventilation, seeking after corresponding pathophysiological and biological characteristics. Methods Between March 22 and March 30, 2020 respiratory mechanics, gas exchanges, circulating endothelial cells (CEC) as markers of endothelial damage, and D-dimers were studied in 22 moderate-to-severe COVID-19 ARDS patients, 1 [1–4] day after intubation (median [IQR]). Measurements and main results Thirteen moderate and 9 severe COVID-19 ARDS patients were studied after initiation of high PEEP protective mechanical ventilation. We observed moderately decreased respiratory system compliance: 39.5 [33.1–44.7] mL/cmH2O and end-expiratory lung volume: 2100 [1721–2434] mL. Gas exchanges were characterized by hypercapnia 55 [44–62] mmHg, high physiological dead-space (VD/VT): 75 [69–85.5] % and ventilatory ratio (VR): 2.9 [2.2–3.4]. VD/VT and VR were significantly correlated: r2 = 0.24, p = 0.014. No pulmonary embolism was suspected at the time of measurements. CECs and D-dimers were elevated as compared to normal values: 24 [12–46] cells per mL and 1483 [999–2217] ng/mL, respectively. Conclusions We observed early in the course of COVID-19 ARDS high VD/VT in association with biological markers of endothelial damage and thrombosis. High VD/VT can be explained by high PEEP settings and added instrumental dead space, with a possible associated role of COVID-19-triggered pulmonary microvascular endothelial damage and microthrombotic process.

Combined Renal-Pulmonary Extracorporeal Support with Low Blood Flow Techniques: A Retrospective Observational Study (CICERO Study)

2021 ◽  
pp. 1-10
Author(s):  
Guglielmo Consales ◽  
Lucia Zamidei ◽  
Franco Turani ◽  
Diego Atzeni ◽  
Paolo Isoni ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Multiorgan Failure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Kidney Injury ◽  
Protective Ventilation ◽  
Retrospective Observational Study ◽  
Organ Support ◽  
Chronic Obstructive

<b><i>Background:</i></b> Critically ill patients with acute respiratory failure frequently present concomitant lung and kidney injury, within a multiorgan failure condition due to local and systemic mediators. To face this issue, extracorporeal carbon dioxide removal (ECCO<sub>2</sub>R) systems have been integrated into continuous renal replacement therapy (CRRT) platforms to provide a combined organ support, with efficient clearance of CO<sub>2</sub> with very low extracorporeal blood flows (&#x3c;400 mL/min). <b><i>Objectives:</i></b> To evaluate efficacy and safety of combined ECCO<sub>2</sub>R-CRRT support with PrismaLung®-Prismaflex® in patients affected by hypercapnic respiratory acidosis associated with AKI in a second level intensive care unit. <b><i>Methods:</i></b> We carried out a retrospective observational study enrolling patients submitted to PrismaLung®-Prismaflex® due to mild to moderate acute respiratory distress syndrome (ARDS) or acute exacerbation of chronic obstructive pulmonary disease (aeCOPD). The primary endpoints were the shift to protective ventilation and extubation of mechanically ventilated patients and the shift to invasive mechanical ventilation of patients receiving noninvasive ventilation (NIV). Clinical-laboratoristic data and operational characteristics of ECCO<sub>2</sub>R-CRRT were recorded. <b><i>Results:</i></b> Overall, 12/17 patients on mechanical ventilation shifted to protective ventilation, CO<sub>2</sub> clearance was satisfactorily maintained during the whole observational period, and pH was rapidly corrected. Treatment prevented NIV failure in 4 out of 5 patients. No treatment-related complications were recorded. <b><i>Conclusion:</i></b> ECCO<sub>2</sub>R-CRRT was effective and safe in patients with aeCOPD and ARDS associated with AKI.

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