scholarly journals Preoperative Evaluation, Anesthesia and Outcome of a Super Morbidly Obese Patient.

2020 ◽  
Vol 4 (2) ◽  
pp. 733-737
Author(s):  
Majlinda NAÇO ◽  
Haxhire GANI ◽  
Nertila KODRA ◽  
Etmont ÇELIKU ◽  
Alma LLUKAÇAJ ◽  
...  
Keyword(s):  
Perioperative Management ◽  
Severe Hypertension ◽  
Preoperative Evaluation ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Hypertension Treatment ◽  
Morbidly Obese Patient ◽  
Metabolic Systems ◽  
Life Threatening ◽  
Weaning Criteria

Background; Nowadays anesthesia and outcome of morbidly obese patients became not only challenges but and an obligation in abdominal surgery. Sometimes morbidly obese patients postponed from all the kinds of surgery till it is life-threatening. The ward of anesthetists is obligate for a very careful preoperative evaluation, anesthesia, and outcome of morbidity obese patients. These include the preoperative evaluation of obesity, particularly on cardiac, respiratory, and metabolic systems; airway management; perioperative management (i.e., hemodynamic, respiratory, and hyperglycemic) and postoperative care. Case description: A 62 years old female with BMI=63.7 kg/m² with severe hypertension treatment came to a surgery ward for the plastic abdomen. After a careful preoperative preparation for the respiratory system and prophylaxis for thrombosis home, we started preoperative care 72 hours before surgery done in our hospital. We used general anesthesia for operation, the surgery lasts 190 minutes, and the patient was extubated according to weaning criteria only 16 hours after surgery. The patient stayed 2 days in intensive care and left a safe hospital on her ten days of recovery. Discussion:  Super obese surgical patients represent numerous challenges to the anesthetist. Conclusion: A better understanding of the pathophysiology and complications that accompany obesity may improve their care and outcome.

Obstructive Sleep Apnea

2018 ◽  
Author(s):  
Tomasz G. Rogula ◽  
Adriana Martin ◽  
Ivan Alberto Zepeda Mejia
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Management ◽  
Perioperative Management ◽  
Perioperative Period ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Preoperative Screening ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is highly prevalent in morbidly obese patients, although it is surprisingly underdiagnosed and undertreated. OSA can increase the risk of serious and life-threating complications in the perioperative period of bariatric surgery. Nevertheless, this potential risk can be minimized with adequate preoperative screening and perioperative management. The perioperative management of patients with OSA will affect the preparation for surgery, airway management, anesthetic selection, and monitoring. This chapter discusses and presents the best evidences available for the management of patients with OSA in order to decrease both the prevalence of undiagnosed patients and the morbidity associated with bariatric surgery.

P0264ASSESSMENT OF GFR IN MORBIDLY OBESE PATIENTS USING DIFFERENT EQUATIONS: WHICH IS THE BEST?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alaa Sabry ◽  
Amir Basiony ◽  
Mohamed Kamal
Keyword(s):  
Body Weight ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Total Body Weight ◽  
Lean Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbidly Obese Patient ◽  
Gault Formula ◽  
Total Body

Abstract Background and Aims Obesity is a potent risk factor for the development of kidney disease. The prevalence of abdominal obesity in Egyptians based upon the European cut-off points was 30.2% for men and 70.9% for women. To detect the best formula for estimation of glomerular filtration rates in morbidly obese individuals. Method: In this prospective study 82 morbidly obese patients were included, Age: 15 to 65 years, Morbidly obese patient (BMI > 40 Kg/m2), Creatinine clearance calculated from a 24-h urine was done, Estimated glomerular filtration rate (eGFR): It was assessed to be correlated with creatinine clearance and detect the most suitable formula for morbidly obese patients. Cockcroft-Gault formula:  Cockcroft-Gault formula (for total body weight): ockcroft-Gault formula (for adjusted body weight): Cockcroft-Gault formula (for lean body weight), MDRD-eGFR (Modification of Diet in Renal Disease equation) (Shahbaz & Gupta, 2019), CKD-epidemiology (CKD-EPI): (Levey, et al, 2009) Results Demogrphic criteria of the studdied patients Conclusion: The equations that had the nearest values to creatinine clearance were CG-TBW-GFR and CGAjBW- GFR, both of them had a moderate reliability with more agreement for the CG-TBW-GFR equation . The CG-TBW-GFR formula was the most reliable one to measure GFR, followed by the CG-AjBW-GFR formula, while the CG-IBW, CG-LBW, MDRD-GFR and CKD-EPI-GFR formulae were not reliable at all .

Continuous Spinal Anesthesia/Analgesia for Perioperative Management of Morbidly Obese Patients Undergoing Laparotomy for Gastroplastic Surgery

2000 ◽  
Vol 10 (3) ◽  
pp. 220-229 ◽  
Author(s):  
D. Michaloudis ◽  
O. Fraidakis ◽  
A. Petrou ◽  
H. Farmakalidou ◽  
M. Neonaki ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Perioperative Management ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Continuous Spinal Anesthesia

scholarly journals Neurosurgery in morbidly obese patients

2016 ◽  
Vol 03 (01) ◽  
pp. 003-008
Author(s):  
S. Mohanaselvi ◽  
Rajkumar Subramanian ◽  
Arijit Sardar ◽  
Rahul Anand ◽  
Anil Agarwal ◽  
...  
Keyword(s):  
Obese Patient ◽  
Anaesthetic Management ◽  
The Body ◽  
Morbidly Obese ◽  
Operating Table ◽  
Obese Patients ◽  
Morbidly Obese Patient ◽  
Normal Individuals ◽  
Organ Systems ◽  
Neurosurgical Patients

AbstractObesity has significant impact on various organ systems of the body and thus needs a well-planned anaesthetic management. Obese patients with multiple co morbidities are expected to have more complications than normal individuals. Obesity may influence the risk of aneurysm formation and rupture and/or the outcome of patients who have aneurysmal SAH. Most of the neurosurgeries require different patient positions for adequate exposure of surgical site. Moreover morbidly obese patient means a huge and heavy patient who will require bigger operating table and other accessories and their implications. Confusion regarding the risks and benefits of mechanical and pharmacological prophylaxis in neurosurgical patients for DVT with risks of major and minor haemorrhage still persists. The anesthetic concerns in an obese patient undergoing neurosurgery have not been studied so far. This review aims in discussing obesity in neurosurgical patients.

scholarly journals Respiratory Care of the Morbidly Obese Patient

2016 ◽  
Vol 01 (01) ◽  
pp. 25
Author(s):  
John D Davies ◽  
Keyword(s):  
Respiratory Mechanics ◽  
Protective Ventilation ◽  
Lung Protective Ventilation ◽  
Respiratory Care ◽  
Morbidly Obese ◽  
Obese Patients ◽  
The Past ◽  
Morbidly Obese Patient ◽  
Clinical Scenarios ◽  
Prevalence Of Obesity

The prevalence of obesity has been on the rise for the past couple of decades. Although the prevalence has stabilized, it remains quite high. Morbidly obese patients pose many challenges for the clinician. These patients have altered respiratory mechanics and lung volumes that combined with excessive adipose tissue surrounding the thorax and in the airway, affect how clinicians need to approach the situation in terms of both mechanical ventilation and airway management. In particular, with the advent of “lung-protective” ventilation, clinicians need to be aware of what the ventilating pressures are doing (or not doing) in these altered clinical scenarios.

scholarly journals Caesarean section in morbidly obese parturient: Technical difficulties

2020 ◽  
Vol 9 (1) ◽  
pp. 60-62
Author(s):  
Tanya Das ◽  
Rachana Saha ◽  
Rosina Manandhar
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Reproductive Age ◽  
Morbidly Obese ◽  
Hypertensive Retinopathy ◽  
Chronic Hypertension ◽  
Obese Patients ◽  
Women Of Reproductive Age ◽  
Morbidly Obese Patient ◽  
Reproductive Age Group

Approximately one third of women of reproductive age group are obese. Obesity significantly increases caesarean section rate. Not only is obesity associated with unfavourable clinical outcomes for both mother and childalso, performing caesarean sections in morbidly obese patients is a challenge for obstetricians, anaesthetists and the caregivers. In view of increased risks while performing Caesarean delivery in morbidly obese patient, this case report reviews the techniques and incisions used; the anaesthetic, logistical and practical challenges faced by the obstetricians while performing an emergency caesarean section in a women with BMI of 45.78kg/m2 who was also a diagnosed case of chronic hypertension with Grade I hypertensive retinopathy.

scholarly journals Therapeutic Enoxaparin in the Morbidly Obese Patient: A Case Report and Review of the Literature

2018 ◽  
Vol 54 (6) ◽  
pp. 371-377
Author(s):  
Claudia M. Hanni ◽  
Sheila M. Wilhelm ◽  
Bianca Korkis ◽  
Elizabeth A. Petrovitch ◽  
Kanella V. Tsilimingras ◽  
...  
Keyword(s):  
Limb Ischemia ◽  
Total Body Weight ◽  
Morbidly Obese ◽  
Low Molecular Weight ◽  
Obese Patients ◽  
Review Of The Literature ◽  
Suspected Pulmonary Embolism ◽  
Morbidly Obese Patient ◽  
Total Body ◽  
Bridge Therapy

Enoxaparin is a low molecular weight heparin commonly used in the treatment of venous thromboembolisms (VTEs); however, evidence on optimal empiric dosing recommendations are lacking in patients with morbid obesity. Utilization of an absolute dose cap, anti-Xa monitoring, and reduced empiric dosing are among the techniques used in this population. We describe a case of a morbidly obese man (body-mass index, BMI: 68.2 kg/m2, total body weight: 236 kg) who required therapeutic enoxaparin for suspected pulmonary embolism (PE) and critical limb ischemia as a bridge therapy during warfarin initiation. An initial empiric dose of 200 mg Q12 hours (0.85 mg/kg) resulted in an anti-Xa level of 1.01 IU/mL following the fifth dose, and no dose modification was deemed necessary. He experienced no adverse effects from treatment. This report adds to a growing body of evidence illustrating the need for reduced empiric weight-based doses of enoxaparin in the morbidly obese population and raises the question of whether dose capping is an appropriate practice in the clinical setting of morbidly obese patients with acute VTE.

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