Mechanical Ventilation in the Critically Ill Obese Patient

1. Front Matter

   Pages i-xii

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2. Effects of Obesity on Respiratory Physiology

   1. Front Matter

      Pages 1-1

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   2. Control of Ventilation in Obesity

      • Nikolaos Markou, Heleni Stefanatou, Maria Kanakaki

      Pages 3-13

   3. Obesity, Respiratory Mechanics and Its Impact on the Work of Breathing, Neural Respiratory Drive, Gas Exchange and the Development of Sleep-Disordered Breathing

      • Culadeeban Ratneswaran, Patrick Murphy, Nicholas Hart, Joerg Steier

      Pages 15-25

   4. Implications of Obesity for Mechanical Ventilation

      • Paolo Formenti, John J. Marini

      Pages 27-39

3. Causes of Acute Respiratory Failure in the Obese Patient

   1. Front Matter

      Pages 41-41

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   2. Obesity and Comorbidities

      • Cintia Zappe Fiori, Denis Martinez, Alicia Carissimi

      Pages 43-49

   3. Atelectasis

      • Sevinc Sarinc Ulasli

      Pages 51-55

   4. Obesity and Congestive Heart Failure

      • Stephan Steiner

      Pages 57-64

   5. Intra-abdominal Hypertension and Abdominal Compartment Syndrome: Consequences for Mechanical Ventilation

      • Peter D. Liebling, Behrouz Jafari

      Pages 65-75

   6. Impact of Sleep Breathing Disorders in Obese Critically Ill Patients

      • Moh’d Al-Halawani, Christine Won

      Pages 77-85

   7. Drugs and Medications

      • Clement Lee, Kate Millington, Ari Manuel

      Pages 87-96

4. Invasive Mechanical Ventilation in the Critically Ill Obese Patient

   1. Front Matter

      Pages 97-97

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   2. Preoxygenation Before Intubation in the Critically Ill Obese Patient

      • Francesco Zarantonello, Carlo Ori, Michele Carron

      Pages 99-108

   3. Analgesia in the Obese Patient

      • Preet Mohinder Singh, Adrian Alvarez

      Pages 109-121

   4. Sedation of the Obese Patient: Indications, Management, and Complications

      • Krysta Wolfe, John Kress

      Pages 123-138

   5. Positioning of the Critically Ill Obese Patient for Mechanical Ventilation

      • Malcolm Lemyze

      Pages 139-144

   6. Obesity and Positive End-Expiratory Pressure (PEEP)-Obesity and Recruitment Maneuvers During the Intraoperative Period

      • Seniyye Ulgen Zengin, Güniz Köksal

      Pages 145-149

   7. Complications Associated with Invasive Mechanical Ventilation in Obese Patients

      • Nishant Chauhan

      Pages 151-156

   8. Management of Ventilator-Induced Lung Injury

      • Sven Stieglitz

      Pages 157-161

This book is the first to describe a practical evidence-based approach to the management of critically ill obese patients with various medical or postoperative respiratory problems in the intensive care unit. In brief, the book aims to identify the best strategy and present clinical recommendations for different circumstances, to establish indications for and contraindications to noninvasive and invasive mechanical ventilation, and to offer clear guidance on weaning from mechanical ventilation and on respiratory care. Causes of acute respiratory failure in the obese patient are discussed, and advice is offered on the prevention and management of complications during mechanical ventilation and on moving and feeding critically ill obese patients. Long-term outcomes, ethical issues, and health care costs are also addressed. The multidisciplinary approach, with contributions from international experts in different specialties, ensures that the book will be of interest to a range of health professionals involved in critical care, including intensivists, anesthesiologists, and pulmonologists.

• Nasal high-flow therapy
• Non-invasive mechanical ventilation
• Critical care
• Obesity
• Mortality
• Complications of mechanical ventilation
• Weaning from ventilation
• Acute respiratory failure
• Sleep-disordered breathing
• Oxygen delivery

“This book is a comprehensive, internationally oriented guide for health care providers, managers, and specialists engaged in the care of these challenging patients. It considers the specific demands and peculiarities of this patient population and offers valuable clinical recommendations and guidance on respiratory care.” (Anesthesia & Analgesia, Vol. 27 (06), December, 2018)



“Senior trainees, fellows, and attending anesthesiologists, intensivists, and pulmonologists treating morbidly obese patients are an appropriate audience for this book, written by an international cast of contributors. … Given the international group of authorities and the breadth of topics, this book is an important contribution to our understanding of respiratory management in the obese patient.” (David J. Dries, Doody's Book Reviews, February, 2018)

• Intensive Care and Non Invasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain

  Antonio M. Esquinas

• Dept Respiratory and CC Medicine, Schaffner Hospital, Lens, France

  Malcolm Lemyze

Antonio M. Esquinas, MD, PhD, is a member of staff on the Intensive Care Unit and Non-invasive Ventilatory Unit at Hospital General Universitario Morales Meseguer, Murcia, Spain. Prior to taking up this position in January 2013, he worked in the Departments of Anesthesiology, Critical Care, and Pain Medicine at Sapienza University of Rome, Italy. Dr. Esquinas is a Fellow of the College of Chest Physicians and an International Fellow of the American Association of Respiratory Care. He is Director of the International School of Non-invasive Mechanical Ventilation and President of the International Association of NIV and the Ibero-American  Association of  Bioethics in NIV. He is the author of well over 700 scientific publications, including almost 400 articles and 32 books.

Malcolm Lemzye, MD, is a Specialist in Respiratory and Critical Care Medicine in the Department of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens, France. He had previously held a similar position at Broussais Hospital, Saint Malo (2008–9) and was a Clinical Fellow in Critical Care Medicine and Hyperbaric Medicine at Calmette Hospital, Lille (2006–8). Dr. Lemzye obtained his medical degree from 2 University Medical School, Lille in 2001 and subsequently completed his board certification in Critical Care in Pneumonology in 2006 and in Critical Care in 2008. He is the author of more than 40 articles in international peer-reviewed journals.

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