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Obesity and Obesity Hypoventilation, Sleep Hypoventilation, and Postoperative Respiratory Failure
- Source :
- Anesthesia & Analgesia. 132:1265-1273
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Obesity hypoventilation syndrome (OHS) is considered as a diagnosis in obese patients (body mass index [BMI] ≥30 kg/m2) who also have sleep-disordered breathing and awake diurnal hypercapnia in the absence of other causes of hypoventilation. Patients with OHS have a higher burden of medical comorbidities as compared to those with obstructive sleep apnea (OSA). This places patients with OHS at higher risk for adverse postoperative events. Obese patients and those with OSA undergoing elective noncardiac surgery are not routinely screened for OHS. Screening for OHS would require additional preoperative evaluation of morbidly obese patients with severe OSA and suspicion of hypoventilation or resting hypoxemia. Cautious selection of the type of anesthesia, use of apneic oxygenation with high-flow nasal cannula during laryngoscopy, better monitoring in the postanesthesia care unit (PACU) can help minimize adverse perioperative events. Among other risk-reduction strategies are proper patient positioning, especially during intubation and extubation, multimodal analgesia, and cautious use of postoperative supplemental oxygen.
- Subjects :
- medicine.disease_cause
Risk Assessment
Hypoxemia
03 medical and health sciences
0302 clinical medicine
Risk Factors
030202 anesthesiology
Obesity Hypoventilation Syndrome
medicine
Humans
Obesity
Lung
Obesity hypoventilation syndrome
business.industry
Respiration
Perioperative
medicine.disease
Hypoventilation
Obstructive sleep apnea
Treatment Outcome
Anesthesiology and Pain Medicine
Respiratory failure
Surgical Procedures, Operative
Anesthesia
medicine.symptom
Pulmonary Ventilation
Respiratory Insufficiency
business
Hypercapnia
Nasal cannula
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00032999
- Volume :
- 132
- Database :
- OpenAIRE
- Journal :
- Anesthesia & Analgesia
- Accession number :
- edsair.doi.dedup.....83c2906d05649e680343d54f7f084cce