Title: Mechanical Ventilation in the Obese Critically Ill Patient<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Mechanical Ventilation in the Obese Critically Ill</u></strong></p>
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Rates of obesity have steadily risen over the past three decades. In fact, the prevalance of obesity in the ICU is now estimated at 20%.</li>
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Obesity affects numerous organ systems and impacts the resuscitation and management of these patients.</li>
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The pulmonary systems undergoes several changes that include decreased lung compliance, decreased chest wall compliance, increased O2 consumption, increased CO2 production, and increased work of breathing.</li>
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When initiating mechanical ventilation in the obese patient without ARDS, consider the following initial settings:
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Tidal volume 6 ml/kg <em>ideal</em> body weight</li>
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PEEP of 10-12 cm H2O</li>
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RR to achieve a PaCO2 35-45 mmHg</li>
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FiO2 to maintain SpO2 92-95%</li>
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Driving pressure < 15 cm H2O</li>
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<fieldset><legend>References</legend>
<p>
Schetz M, et al. Obesity in the critically ill: a narrative review. <em>Intensive Care Med</em>. 2019 [epub ahead of print].</p>
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