scholarly journals Anaesthesiological Maintenance of Patients with Obesity

2008 ◽  
Vol 62 (4-5) ◽  
pp. 189-192
Author(s):  
Margarita Vyzhigina ◽  
Viktor Titov ◽  
Svetlana Zhukova ◽  
Oksana Kurilova
Keyword(s):  
Morbid Obesity ◽  
Body Weight ◽  
Gas Exchange ◽  
High Efficiency ◽  
Lung Ventilation ◽  
Ideal Body Weight ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Ideal Body ◽  
Special Approach

Anaesthesiological Maintenance of Patients with Obesity Pathophysiological features of morbid obesity and the associated functional-anatomical changes in an organism demand the special approach to anaesthesiological maintenance. Methods of anaesthesiological protection and maintenance of effective gas exchange in morbide obesity patients have been proved. Anaesthesias for 110 patients have been analysed. Multicomponent anesthesia with traditional and combined artificial lung ventilation (ALV) (IPPV+HFJV) (intermittent positive pressure ventilation and high frequency jet ventilation) was used. Since 2000, morbid obesity patients receive intubation only with fibrobronchoscope with self breathing under local anesthesia. In IPPV for morbid obesity patients high peak pressure in airways, low V/Q, and low PaO2 occurs. Technology of combined ALV (IPPV+HFJV) has led to pressure decrease in airways and to effective arterial oxygenation improvement, intrapulmonary shunt has decreased. Retrospective analysis of anesthesia components revealed that the applied anaesthetic doses correspond to calculations on ideal body weight, and not true weight. Thus, anaesthesiological maintenance of operated patients with morbid obesity requires trachea intubation with fibroscope under local anaesthesia with self-breathing; high efficiency of ALV methods, allowing lower pressure in airways and high oxygenation (IPPV+HFJV), which provides effective gas exchange; doses correction of intravenous anaesthetics for due body weight is required.

scholarly journals Pharmacokinetics of Sugammadex Dosed by Actual and Ideal Body Weight in Patients With Morbid Obesity Undergoing Surgery

2020 ◽  
Author(s):  
Kate Mostoller ◽  
Rebecca Wrishko ◽  
Lata Maganti ◽  
W. Joseph Herring ◽  
Mariëlle Zutphen‐van Geffen
Keyword(s):  
Morbid Obesity ◽  
Body Weight ◽  
Ideal Body Weight ◽  
Ideal Body

scholarly journals An Evaluation of Systemic Vancomycin Dosing in Obese Patients

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
David W. Kubiak ◽  
Mohammed Alquwaizani ◽  
David Sansonetti ◽  
Megan E. Barra ◽  
Michael S. Calderwood
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Body Weight ◽  
Actual Body ◽  
Initial Dose ◽  
Ideal Body Weight ◽  
Obese Patients ◽  
Actual Body Weight ◽  
Trough Concentrations ◽  
Ideal Body

Abstract We retrospectively identified 67 patients with severe or morbid obesity (body mass index ≥35 kg/m2) who had received intravenous vancomycin at our institution. We observed that an initial dose of 45 to 65 mg/kg vancomycin per day based upon ideal body weight rather than actual body weight was more predictive of initial trough concentrations between 15 and 20 mcg/mL.

scholarly journals Physiological Aspects of Intermittent Positive Pressure Ventilation

1986 ◽  
Vol 14 (3) ◽  
pp. 226-235 ◽  
Author(s):  
D. R. Hillman
Keyword(s):  
Gas Exchange ◽  
Positive Pressure Ventilation ◽  
Volume Flow Rate ◽  
Lung Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Rational Approach ◽  
Positive Pressure ◽  
High Frequency Ventilation ◽  
Potential Hazard ◽  
Frequency Ventilation

The mechanical properties of the lungs and chest wall dictate the relationship between tidal volume, flow rate and airway pressure developed during intermittent positive pressure ventilation (IPPV). The increase in intrathoracic pressures associated with IPPV has consequences for the intrapulmonary distribution of ventilation and perfusion (hence gas exchange), cardiac output and regional blood flows. Barotrauma is a potential hazard. IPPV also affects the homeostatic mechanisms that keep the air spaces dry. Strategies to maximise the benefits and minimise the side effects of IPPV include positive end-expiratory pressure, intermittent mandatory ventilation, differential lung ventilation and high frequency ventilation. Understanding the physiological effects of IPPV and associated therapies allows a rational approach to the adjustment of ventilation against pulmonary, cardiovascular and systemic responses so as to optimise gas exchange and peripheral oxygen delivery.

Sugammadex and morbid obesity; dosage according to total or ideal body weight? A preliminary study

2011 ◽  
Vol 28 ◽  
pp. 134
Author(s):  
Techera L. González ◽  
O. Cervantes ◽  
A. Avecilla ◽  
A. Brunelli ◽  
C. Bertrán ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Body Weight ◽  
Ideal Body Weight ◽  
Ideal Body ◽  
Preliminary Study

Determining Ideal Body Weight (and Mass)

1983 ◽  
Vol 40 (10) ◽  
pp. 1622-1627 ◽  
Author(s):  
Alan W. Hopefl ◽  
Donald R. Miller ◽  
James D. Carlson ◽  
Beverly J. Lloyd ◽  
Brian Jack Day ◽  
...  
Keyword(s):  
Body Weight ◽  
Ideal Body Weight ◽  
Ideal Body

scholarly journals Dosing of neuromuscular blocking agents in patients with obesity: A narrative review

2021 ◽  
pp. 0310057X2096857
Author(s):  
Brian L Erstad ◽  
Jeffrey F Barletta
Keyword(s):  
Body Weight ◽  
Ideal Body Weight ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Patient Specific ◽  
Lean Body Weight ◽  
Short Term ◽  
Blocking Agents ◽  
Ideal Body ◽  
Size Descriptor

There is no consensus on which weight clinicians should use for weight-based dosing of neuromuscular blocking agents (NMBAs), as exemplified by differing or absent recommendations in clinical practice guidelines. The purpose of this paper is to review studies that evaluated various size descriptors for weight-based dosing of succinylcholine and non-depolarising NMBAs, and to provide recommendations for the descriptors of choice for the weight-based dosing of these agents in patients with obesity. All of the studies conducted to date involving depolarising and non-depolarising NMBAs in patients with obesity have assessed single doses or short-term infusions conducted in perioperative settings. Recognising that any final dosing regimen must take into account patient-specific considerations, the available evidence suggests that actual body weight is the size descriptor of choice for weight-based dosing of succinylcholine and that ideal body weight, or an adjusted (or lean) body weight, is the size descriptor of choice for weight-based dosing of non-depolarising NMBAs.

Effect of adrenaline infusion on fatty acid and glucose turnover in lean and obese human subjects in the post-absorptive and fed states

1991 ◽  
Vol 81 (5) ◽  
pp. 635-644 ◽  
Author(s):  
Alan A. Connacher ◽  
William M. Bennet ◽  
Roland T. Jung ◽  
Dennis M. Bier ◽  
Christopher C. T. Smith ◽  
...  
Keyword(s):  
Body Weight ◽  
Energy Expenditure ◽  
Human Subjects ◽  
Ideal Body Weight ◽  
Glycerol Release ◽  
Fed State ◽  
Adrenaline Infusion ◽  
Obese Subjects ◽  
Ideal Body ◽  
Obese Human

1. Energy expenditure, plasma glucose and palmitate kinetics and leg glycerol release were determined simultaneously both before and during adrenaline infusion in lean and obese human subjects. Seven lean subjects (mean 96.5% of ideal body weight) were studied in the post-absorptive state and also during mixed nutrient liquid feeding, eight obese subjects (mean 165% of ideal body weight) were studied in the post-absorptive state and six obese subjects (mean 174% of ideal body weight) were studied during feeding. 2. Resting energy expenditure was higher in the obese subjects, but the thermic response to adrenaline, both in absolute and percentage terms, was similar in lean and obese subjects. Plasma adrenaline concentrations attained (3 nmol/l) were comparable in all groups and the infusion had no differential effects on the plasma insulin concentration. Before adrenaline infusion the plasma glucose flux was higher in the obese than in the lean subjects in the fed state only (45.8 ± 3.8 versus 36.6 ± 1.0 mmol/h, P <0.05); it increased to the same extent in both groups with the adrenaline infusion. 3. Before the adrenaline infusion plasma palmitate flux was higher in the obese than in the lean subjects (by 51%, P <0.01, in the post-absorptive state and by 78%, P <0.05, in the fed state). However, there was no significant change during adrenaline infusion in the obese subjects (from 13.5 ± 1.00 to 15.0 ± 1.84 mmol/h, not significant, in the post-absorptive state and from 14.4 ± 2.13 to 15.7 ± 1.74 mmol/h, not significant, in the fed state), whereas there were increases in the lean subjects (from 8.93 ± 1.10 to 11.2 ± 1.19 mmol/h, P <0.05, in the post-absorptive state, and from 8.06 ± 1.19 to 9.86 ± 0.93 mmol/h, P <0.05, in the fed state). 4. Before adrenaline infusion the palmitate oxidation rate was also higher in the obese than in the lean subjects (1.86 ± 0.14 versus 1.22 ± .09 mmol/h, P <0.01, in the post-absorptive state and 1,73 ± 0.25 versus 1.12 ± 0.12 mmol/h, P <0.05, in the fed state). However, in response to adrenaline the fractional oxidation rate (% of flux) increased less in the obese than in the lean subjects, especially in the post-absorptive state (from 13.8 ± 1.02 to 14.9 ± 1.39%, not significant, versus from 13.7 ± 0.98 to 19.3 ± 1.92%, P <0.05). These effects were independent of feeding. Leg glycerol release increased more in the lean subjects with adrenaline infusion, although increases in the plasma glycerol concentration did not differ between the groups. 5. These results suggest that in obese subjects plasma inter-organ transport of fatty acids and the subsequent fractional oxidation responses favour storage of triacylglycerol. These factors may be important determinants for the development and maintenance of the obese state.

Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis

PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 522-522
Author(s):  
ALBERT C. HERGENROEDER
Keyword(s):  
Cystic Fibrosis ◽  
Eating Disorders ◽  
Body Weight ◽  
Growth Curves ◽  
Ideal Body Weight ◽  
Menstrual Function ◽  
Ideal Body ◽  
The Ideal

To the Editor.— This letter is in response to the article entitled "Weight and Menstrual Function in Patients with Eating Disorders and Cystic Fibrosis."1 Under "Methods," the authors describe a method for calculating percent ideal body weight by plotting the patient's height on standard growth curves derived from the data of Hamill et al,2 and the ideal body weight being the weight at the same percentile for age. Using the tables of Hamill to calculate percentages of height and weight for females older than 10 years and males older than 11½ years should be done cautiously.

Body Shaping Through Aerobic Training in the Gym in Adult Women

2020 ◽  
Vol 65 (4) ◽  
pp. 97-107
Author(s):  
Alexandra Giurgiu ◽  
Iacob Hanțiu
Keyword(s):  
Body Weight ◽  
Physical Training ◽  
Aerobic Training ◽  
Ideal Body Weight ◽  
The Body ◽  
Adult Women ◽  
Hip Circumference ◽  
Positive Effects ◽  
Ideal Body ◽  
Training Exercises

ABSTRACT. Introduction. Regular physical activity has positive effects on human body composition, even if not combined with a diet. For many people this activity aims to reduce the amount of fat in some areas of the body and targets body shaping. Objectives. The main objective of this study was to learn about the effects of a 12-months regular participation in aerobic training exercises. Methods. This study was voluntarily attended by 89 women with an average age of 31.62, practicing aerobic exercises in gyms, three times a week for a period of 12 months. We carried out anthropometric measurements of subjects at the beginning and at end of the study, respectively, and data was statistically analysed using the SPSS 23.0 software. Results. Data collected was statistically processed, showing that participation in physical training led to reducing body weight by 4.81 kg, decrease of adipose tissue - between the two moments there was a difference of 5 % - fat mass decreased by 4.26 kg, and lean body mass by 0.55 kg. Significant decrease in chest, waist and hip circumference was also noticed. Conclusions. Regular participation in physical training programs involving aerobic exercise for 12 months has had the effect of reducing body weight and the amount of fat in some areas of the body, materialized by decreasing the value of the circumference of the chest, waist and hips, with the intention of reaching the ideal body weight and aiming for body shaping.

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