The Bariatric Patient in the Intensive Care Unit: Pitfalls and Management.

Carlos E Pompilio, Paolo Pelosi, Melina G Castro

Journal: Current atherosclerosis reports 2017;18(9):55

PMID: 27464648

Abstract

The increasing number of bariatric/metabolic operations as important alternatives for the treatment of obesity and type 2 diabetes brought several concerns about the intensive care of patients undergoing those procedures. Intensive Care Unit admission criteria are needed in order to better allocate resources and avoid unnecessary interventions. Furthermore, well-established protocols, helpful in many clinical situations, are not directly applicable to obese patients. Indeed, difficult airway management, mechanical ventilation, fluid therapy protocols, prophylaxis, and treatment of venous thromboembolic events have unique aspects that should be taken into consideration. Finally, new data related to planning nutrition therapy of the critically obese have been highlighted and deserve consideration. In this review, we provide an outline of recent studies related to those important aspects of the care of the bariatric/metabolic patients in critical conditions.

Address: The Center for Diabetes and Obesity, Oswaldo Cruz Hospital, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil. [email protected].; IRCCS San Martino IST, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.; Hospital Mário Covas and Hospital de Ensino Anchieta da Faculdade de Medicina do ABC, Grupo de Assistência Nutricional Enteral e Parenteral (GANEP), São Paulo, Brazil.

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