Critical Care Management of the Obese Patient

Ali El Solh, MD, is an Associate Professor of Medicine, Anesthesiology, and Social and Preventive Medicine at the State University of New York at Buffalo. He is a practicing physician and has been Director of the Critical Care Unit for more than 12 years. Dr El Solh has numerous publications on the subjects of obesity and critical care (59 articles listed in PubMed) plus several monographs on the subjects.

List of Contributors, viii Preface, xiii

Part I Physiology and Consequences of Obesity

1 Cardiovascular Physiology in Obesity, 3
Eric J. Chan and Martin A. Alpert

2 Effects of Obesity on Respiratory Physiology, 13
Philippe Abou Jaoude, Jahan Porhomayon, and Ali A. El Solh

3 Gastrointestinal Physiology in Obesity, 21
Alexander D. Miras and Carel W. le Roux

4 Metabolic and Endocrine Physiology in Obesity, 28
Paula Alvarez-Castro, Susana Sangiao-Alvarellos, and Fernando Cordido

5 Renal Physiology in the Critically Ill Obese Patient, 38
Eric A.J. Hoste and Jan J. De Waele

Part II Positive Pressure Ventilation

6 Sedation, Paralysis, and Pain Management of the Critically Ill Obese Patient, 47
Christopher G. Hughes, Lisa Weavind, and Pratik P. Pandharipande

7 Upper Airway Management in the Morbidly Obese Patient, 58
Michael Tielborg and Anthony Passannante

8 Mechanical Ventilation of the Obese Patient, 67
Mohammed Mogri and M. Jeffery Mador

9 Management of Acute Lung Injury in the Obese Patient, 74
Hallie C. Prescott and James M. O’Brien Jr

Part III Management of Obesity Complications in Critical Care

10 Management of Infectious Complications in the Critically Ill Obese Patient, 85
Kristin Turza Campbell, Laura H. Rosenberger, Amani D. Politano, Tjasa Hranjec, and Robert G. Sawyer

11 Management of Gastrointestinal Complications in the Critically Ill Obese Patient, 93
Benjamin H. Levy III and David A. Johnson

12 Management of Endocrine Complications in the Critically Ill Obese Patient, 102
Joseph Varon and Ilse M. Espina

13 Management of Venous Thromboembolism in the Critically Ill Obese Patient, 108
Terence K. Trow and Richard A. Matthay

14 Nursing Care of the Critically Ill Obese Patient, 116
Margaret E. McAtee

Part IV Hemodynamic Monitoring and Radiological Investigations

15 Hemodynamic Monitoring of the Critically Ill Obese Patient, 125
Wim K. Lagrand, Eline R. van Slobbe-Bijlsma, and Marcus J. Schultz

16 Diagnostic Imaging of the Critically Ill Obese Patient, 135
Venkata S. Katabathina, Neeraj Lalwani, Carlos S. Restrepo, and Srinivasa R. Prasad

Part V Postsurgical Management

17 Postoperative Care of the Obese Patient, 149
Hui Sen Chong and Robert L. Bell

18 Management of the Obese Patient with Trauma, 159
Hadley K. Herbert and Therèse M. Duane

19 Abdominal Solid Organ Transplantation in the Obese Patient, 169
Erin C. Hall and Dorry L. Segev

20 Critical Care Management of the Obese Patient after Bariatric Surgery, 179
Scott E. Mimms and Samer G. Mattar

21 Nutritional Requirements of the Critically Ill Obese Patient, 186
Bikram S. Bal, Frederick C. Finelli, and Timothy R. Koch

Part VI Pharmacology

22 Drug Dosing in the Critically Ill Obese Patient, 197
Brian L. Erstad

Part VII Prognosis and Ethics

23 Prognosis and Outcome of the Critically Ill Obese Patient, 211
Yasser Sakr, Mohamed Zeiden, and Juliana Marques

24 Ethical Considerations in the Critically Ill Obese Patient, 218
Mark D. Siegel

Multiple Choice Questions, 225

Answers to Multiple Choice Questions, 234

Index, 236