Mechanical Ventilation in the Critically Ill Obese Patient

Mechanical Ventilation in the Critically Ill Obese Patient Antonio M. Esquinas Malcolm Lemyze Editors 123 Mechanical Ventilation in the Critically Ill Obese Patient Antonio M. Esquinas • Malcolm Lemyze Editors Mechanical Ventilation in the Critically Ill Obese Patient Editors Antonio M. Esquinas Malcolm Lemyze Intensive Care and Non Invasive Department Respiratory and CC Medicine Ventilatory Unit Schaffner Hospital Hospital Morales Meseguer Lens Murcia France Spain ISBN 978-3-319-49252-0 ISBN 978-3-319-49253-7 (eBook) https://doi.org/10.1007/978-3-319-49253-7 Library of Congress Control Number: 2017955688 © Springer International Publishing AG 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface There is no doubt that obesity has become one of the leading public health threats worldwide. The number of obese subjects has doubled during the last 25 years to reach more than 600 million subjects in 2015. Considering the 100 million obese children in the world, obesity’s future is assured at least for the next generation. Of course, the continuously increasing incidence of the disease is problematic, but the new alarming phenomenon is the explosion of the cases of massively obese indi- viduals. Indeed, the higher the severity of obesity according to body mass index, the higher the incidence of obesity-associated cardio-respiratory disorders and meta- bolic diseases. Obesity-induced chronic respiratory failure—commonly referred to as obesity hypoventilation syndrome—is encountered in more than half of the superobese patients with a BMI exceeding 50 kg·m−2. The management of these patients in the emergency setting is often challenging and raises specific problems that must be addressed and overcome at the bedside in a short time. At the interface between multiple health specialties, the obese patient usually requires a time- consuming multidisciplinary approach involving different stakeholders in respiratory care, cardiovascular diseases, endocrinology, surgery, anesthesiology, and also a necessary implication of the nursing staff. This book is intended to highlight the critically ill obese patient’s specificities that must be taken into account when mechanical ventilation is part of the therapeutic management of such a patient. Given the singularity of the massively obese critically ill patient, it can be assumed that an individualizing care approach is particularly adapted for this topic. Good knowledge of the respiratory physiology and cardio-respiratory interactions appears to be an essential prerequisite to the management of a critically ill obese patient, especially when oxygenation and mechanical ventilation are needed. The first part of the book is devoted to delivering insight into the basic understanding of the phys- iological characteristics of the respiratory system of the obese patient and their implications for mechanical ventilation. The second part deals with the comorbidities of the obese patient and the causes of acute respiratory failure that can impact on the outcome. The third part of the book includes chapters about preoxygenation, positioning, recruitment strategy, sedation and analgesia during invasive mechanical ventilation, and its associated complications. Another part is about noninvasive ventilation and the promising technique of high-flow oxygen via nasal cannula, which both have the potential to avoid the resort to invasive mechanical ventilation in many situations. Finally, nutritional support and outcome after mechanical v vi Preface ventilation are two main issues that are developed in the last part. We are convinced that this book provides a useful didactic tool for an everyday practice of critical care medicine in obese patients with respiratory failure. Both editors are very grateful to all authors for their valuable contribution to the book. We are deeply aware of the time they spent in writing the chapters, making it possible to share their knowledge and expertise with the readers. We greatly appre- ciate having so many internationally recognized experts in the field of obesity and mechanical ventilation who accepted to participate in the writing of this book. Lens, France Malcolm Lemyze, M.D. Murcia, Spain Antonio M. Esquinas, M.D., Ph.D. Contents Part I Effects of Obesity on Respiratory Physiology 1 Control of Ventilation in Obesity �� 3 Nikolaos Markou, Heleni Stefanatou, and Maria Kanakaki 2 Obesity, Respiratory Mechanics and Its Impact on the Work of Breathing, Neural Respiratory Drive, Gas Exchange and the Development of Sleep-Disordered Breathing �� 15 Culadeeban Ratneswaran, Patrick Murphy, Nicholas Hart, and Joerg Steier 3 Implications of Obesity for Mechanical Ventilation �� 27 Paolo Formenti and John J. Marini Part II Causes of Acute Respiratory Failure in the Obese Patient 4 Obesity and Comorbidities �� 43 Cintia Zappe Fiori, Denis Martinez, and Alicia Carissimi 5 Atelectasis �� 51 Sevinc Sarinc Ulasli 6 Obesity and Congestive Heart Failure �� 57 Stephan Steiner 7 Intra-abdominal Hypertension and Abdominal Compartment Syndrome: Consequences for Mechanical Ventilation �� 65 Peter D. Liebling and Behrouz Jafari 8 Impact of Sleep Breathing Disorders in Obese Critically Ill Patients �� 77 Moh’d Al-Halawani and Christine Won 9 Drugs and Medications �� 87 Clement Lee, Kate Millington, and Ari Manuel vii viii Contents Part III Invasive Mechanical Ventilation in the Critically Ill Obese Patient 10 Preoxygenation Before Intubation in the Critically Ill Obese Patient �� 99 Francesco Zarantonello, Carlo Ori, and Michele Carron 11 Analgesia in the Obese Patient �� 109 Preet Mohinder Singh and Adrian Alvarez 12 Sedation of the Obese Patient: Indications, Management, and Complications �� 123 Krysta Wolfe and John Kress 13 Positioning of the Critically Ill Obese Patient for Mechanical Ventilation �� 139 Malcolm Lemyze 14 Obesity and Positive End-Expiratory Pressure (PEEP)-Obesity and Recruitment Maneuvers During the Intraoperative Period �� 145 Seniyye Ulgen Zengin and Güniz Köksal 15 Complications Associated with Invasive Mechanical Ventilation in Obese Patients �� 151 Nishant Chauhan 16 Management of Ventilator-Induced Lung Injury �� 157 Sven Stieglitz 17 Ventilation Modes for Obese Patients Under Mechanical Ventilation �� 163 Rachel Jones, Jason Gittens, and Ari Manuel 18 Obesity and Tracheostomy: Indications, Timing, and Techniques �� 179 Bahman Saatian and Julie H. Lyou 19 Decannulation Process in the Tracheostomised Obese Patients �� 187 Pia Lebiedz, Martin Bachmann, and Stephan Braune Part IV Noninvasive Ventilation and Oxygen Delivery in the Critically Ill Obese Patient 20 The Choice of Interface �� 193 Ahmed S. BaHammam, Tripat Singh, and Antonio M. Esquinas 21 The Choice of Ventilator and Ventilator Setting �� 199 Ebru Ortaç Ersoy 22 Obesity and Bi-level Positive Airway Pressure �� 205 Ayelet B. Hilewitz, Andrew L. Miller, and Bushra Mina Contents ix 23 High-Flow Nasal Cannula Therapy: Principles and Potential Use in Obese Patients

Load more