By Ali El Solh
This publication offers wellbeing and fitness execs with sound scientific recommendation on management of the overweight sufferer admitted into medical institution. It addresses all facets of the patient's care, in addition to serving as a source to facilitate the administration of providers, use of scientific details, and negotiation of moral matters that happen in in depth care. because the variety of overweight sufferers in extensive care maintains to develop, this publication will function a accomplished scientific source for daily use via either weight problems experts and emergency drugs physicians.
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Extra resources for Critical Care Management of the Obese Patient
Some in vitro studies, as well as human studies, suggest that lower lung volumes secondary to obesity lead to a reduction in peripheral airway diameter, which over time causes smooth muscle dysfunction, and causes both airways obstruction and hyperresponsiveness. In addition, leptin has been suggested to be involved in the airway dysfunction associated with obesity through its proinflammatory properties and/or via a direct effect on airways smooth muscles . However, the data addressing this question have been inconclusive so far and further studies are needed to understand the mechanism of increased airway resistance and responsiveness in obesity [37,39–45].
An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027–31. 66 Turnbaugh PJ, et al. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008;3(4):213–23. 67 Ley RE, et al. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444(7122):1022–3. 68 Schwiertz A, et al. Microbiota and SCFA in lean and overweight healthy subjects. Obesity (Silver Spring). 2010;18(1):190–5.
Nevertheless, the lower VO2 standardized to body size does not ameliorate the detrimental impact of morbid obesity on oxygen consumption. This respiratory inefficiency results in a limited ventilatory reserve, which predisposes these patients to respiratory failure in the setting of acute pulmonary or systemic illnesses [52,53]. VENTILATION/PERFUSION Ventilation in nonobese patients is greatest in dependent lung zones and decreases toward the upper zones; however, this distribution may be reversed in obesity.