Cic edizioni internazionali
Shortness of Breath

In-hospital management of obesity-related respiratory failure

Review, 84 - 91
doi: 10.11138/sob/2016.5.2.084
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Despite the high prevalence of obesity and its associated respiratory complications, obesity-related respiratory failure remains frequently missed during acute admissions to hospital. Even when respiratory failure is severe and requiring critical care it may be attributed to factors other than obesity.
The acute management of such patients involves the identification and treatment of the underlying precipitant of decompensation, such as acute infection, with supportive management of respiratory failure. When possible, this should be delivered non-invasively to reduce the morbidity associated with invasive mechanical ventilation.
However, the outcome of patients with obesity in critical care is often above that which may be expected and obesity alone should not preclude escalation to invasive ventilation. Adequate non-invasive ventilation set up is required to ensure adequate maintenance of physiological parameters.
Once the acute insult has resolved thought should be given to assessment and management of any chronic respiratory failure with home mechanical ventilation. This should be operated by centres experienced with the use and provision of home mechanical ventilation.