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Intensive Care Med. 2008 Nov;34(11):1991-8. doi: 10.1007/s00134-008-1245-y. Epub 2008 Aug 1.

Impact of obesity in mechanically ventilated patients: a prospective study.

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1
Medical ICU, CHU Poitiers, Poitiers, France. j.p.frat@chu-poitiers.fr

Abstract

OBJECTIVE:

To analyze the influence of severe obesity on mortality and morbidity in mechanically ventilated intensive care unit (ICU) patients.

DESIGN:

Prospective, multi-center exposed/unexposed matched epidemiologic study.

SETTING:

Hospital setting.

PATIENTS:

Severely obese patients (body mass index (BMI) >or= 35 kg/m(2)), mechanically ventilated for at least 2 days were matched with unexposed nonobese patients (BMI < 30 kg/m(2)) for center, gender, age (+/-5 years), and the simplified acute physiology (SAPS) II score (+/-5 points). We recorded tracheal intubation, catheter placement, nosocomial infections, development of pressure ulcers, ICU and hospital outcome.

RESULTS:

Eighty-two severely obese patients (mean BMI, 42 +/- 6 kg/m(2)) were compared to 124 nonobese patients (mean BMI, 24 +/- 4 kg/m(2)). The ICU course was similar in both the groups, except for the difficulties during tracheal intubation (15 vs. 6%) and post-extubation stridor (15% vs. 3%), which were significantly more frequent in obese patients (P < 0.05). The ICU mortality rate did not differ between obese and nonobese patients (24 and 25%, respectively); nor did the risk-adjusted hospital mortality rate (0.76, 95% confidence interval 0.41-1.16 in obese patients versus 0.82, 95% confidence interval 0.54-1.13 in nonobese patients). Conditional logistic regression confirmed that mortality was not associated with obesity.

CONCLUSION:

The only difference in morbidity of obese patients who were mechanically ventilated was increased difficulty with tracheal intubation and a higher frequency of post-extubation stridor. Obesity was not associated either with increased ICU mortality or with hospital mortality.

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PMID:
18670754
DOI:
10.1007/s00134-008-1245-y
[Indexed for MEDLINE]
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