Lifeguard Air Emergency Services, Albuquerque, NM; Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Lifeguard Air Emergency Services, Albuquerque, NM; Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Air Med J. 2022 Jan-Feb;41(1):133-140. doi: 10.1016/j.amj.2021.09.010. Epub 2021 Oct 22.
Morbidly and super obese patients are a unique patient population that presents critical care transport providers with unique clinical and logistical challenges in the setting of respiratory distress and failure. These patients are more likely to have chronic respiratory issues at baseline, unique anatomic and physiologic abnormalities, and other comorbidities that leave them poorly able to tolerate respiratory illness or injury. This requires specialized understanding of their respiratory mechanics as well as how to tailor standard treatment modalities, such as noninvasive ventilation, to meet their needs. Also, careful and deliberate planning is required to address the specific anatomic and physiologic characteristics of this population if intubation and mechanical ventilation are needed. Finally, their dimensions and weight also have distinct consequences on transport vehicle considerations. This article reviews the pathophysiology, management, and critical care transport considerations for this unique patient population in respiratory distress and failure.
病态肥胖和超级肥胖患者是一个独特的患者群体，在呼吸窘迫和衰竭的情况下，为重症监护转运提供者带来了独特的临床和后勤挑战。这些患者在基线时更有可能存在慢性呼吸问题，具有独特的解剖和生理异常，以及其他合并症，使他们无法耐受呼吸疾病或损伤。这需要对他们的呼吸力学有专门的了解，以及如何调整标准治疗方式，如无创通气，以满足他们的需求。此外，如果需要插管和机械通气，则需要仔细和慎重地计划来解决该人群的特定解剖和生理特征。最后，他们的尺寸和重量也对转运车辆的考虑有明显的影响。本文回顾了呼吸窘迫和衰竭时这一独特患者群体的病理生理学、管理和重症监护转运注意事项。
