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重症监护病房中的肥胖症患者:陷阱与管理

The Bariatric Patient in the Intensive Care Unit: Pitfalls and Management.

作者信息

Pompilio Carlos E, Pelosi Paolo, Castro Melina G

机构信息

The Center for Diabetes and Obesity, Oswaldo Cruz Hospital, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil.

IRCCS San Martino IST, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.

出版信息

Curr Atheroscler Rep. 2016 Sep;18(9):55. doi: 10.1007/s11883-016-0606-1.

Abstract

The increasing number of bariatric/metabolic operations as important alternatives for the treatment of obesity and type 2 diabetes brought several concerns about the intensive care of patients undergoing those procedures. Intensive Care Unit admission criteria are needed in order to better allocate resources and avoid unnecessary interventions. Furthermore, well-established protocols, helpful in many clinical situations, are not directly applicable to obese patients. Indeed, difficult airway management, mechanical ventilation, fluid therapy protocols, prophylaxis, and treatment of venous thromboembolic events have unique aspects that should be taken into consideration. Finally, new data related to planning nutrition therapy of the critically obese have been highlighted and deserve consideration. In this review, we provide an outline of recent studies related to those important aspects of the care of the bariatric/metabolic patients in critical conditions.

摘要

作为治疗肥胖症和2型糖尿病的重要替代方法,减肥/代谢手术的数量不断增加,这引发了人们对接受这些手术患者重症监护的诸多担忧。为了更好地分配资源并避免不必要的干预,需要制定重症监护病房的收治标准。此外,在许多临床情况下很有用的既定方案并不直接适用于肥胖患者。事实上,困难气道管理、机械通气、液体治疗方案、静脉血栓栓塞事件的预防和治疗都有其独特的方面,需要加以考虑。最后,与重症肥胖患者营养治疗规划相关的新数据已受到关注,值得考虑。在这篇综述中,我们概述了近期有关肥胖/代谢病重症患者护理这些重要方面的研究。

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