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ISSN 2448-8909 (Print)

2018, Number 5

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Med Crit 2018; 32 (5)

Prognosis of critically ill obese patients under invasive mechanical ventilation

Montaño JA, Olvera GCI, Aguirre SJS, Camarena AG, Franco GJ

Language: Spanish
References: 10
Page: 277-284
PDF size: 192.95 Kb.


ABSTRACT

Introduction: Obesity has become a chronic illness which casually relates with multiple pathologies as well as with an increase in morbidity and mortality rates. On the respiratory system, it diminishes lung compliance, and tidal volume with airway collapse. This issue along with movement limitation from the diaphragm favors lung collapse, and atelectasis appearance causing oxygenation reduction while rising the risk of infection.
Methodology: Retrospective transversal assay performed on patients undergoing invasive mechanical ventilation for over 48 hours. Demographic and mechanical ventilation values are to be evaluated.
Results: 50 patients were analyzed having a tow group distribution, non-obese with a Body mass index (BMI) under 30 kg/m2, and obese with a Body mass index (BMI) over 30 kg/m2, having 35 and 15 patients respectively. A difference between the relation of the values PaO2/FiO2 was found been higher in the non-obese group 193 ± 112 (54-415), while in the obese group it was 116 ± 58 (41-260) p ‹ 0.0001. A bigger value for the Positive end-expiratory pressure (PEEP) was used in obese patients 11 ± 2.8 (5-16) cmH2O compared to the non-obese group with which the PEEP value was 9 ± 2.4 (5-16) cmH2O p ‹ 0.007. The mortality was of 28.6% (n = 10) in the non-obese group while it was 40% (n = 6) in the obese group, no relevant statistical differences were observed. There were no differences in the ventilation time values, neither was a difference for the hospital care or the Intensive Care Unit admission times.
Analysis: No significant difference was observed regarding mortality rates between obese and non-obese group, in contrast to other assays. While a 12% difference was found in the oxygenation values between the two groups, having the obese group a lower oxygenation value.
Conclusion: No significant differences were found in this study. A greater number of patients would be needed to evaluate the effect on the mortality rate.


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