RESUMO
Sculptures from the Stone Age hint at the possibility that morbidly obese humans have always existed. Today, obesity represents a global epidemic with far-reaching consequences affecting health systems worldwide. Increasingly often, anaesthetists and intensivists are challenged with the treatment of extremely obese patients perioperatively. In addition to insufficient logistics and inappropriate technical equipment, the large number of obesity-related diseases, combined with the distinct pathophysiological changes of the respiratory system, put the morbidly obese patient at a significantly increased risk of perioperative complications. If, however, elaborate logistics and adequate airway management--followed by lung protective mechanical ventilation--are combined with appropriately conducted anaesthesia and intensive care, the morbidly obese patients' intensive care survival rates and hospital survival rates can be similar to those of patients of normal weight.
Assuntos
Anestesia , Cuidados Críticos , Obesidade Mórbida/complicações , Respiração Artificial , Adulto , Anestesia por Condução , Criança , Humanos , Medidas de Volume Pulmonar , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/fisiopatologia , Respiração com Pressão Positiva , Fenômenos Fisiológicos Respiratórios , Taxa de SobrevidaRESUMO
Malignant hyperthermia (MH), an inherited myopathia varying in severity and course, is induced by halogenated anesthetic agents and depolarizing muscle relaxants. First recognized as a distinct disease entity in 1960, MH is defined as an anesthesia-related disease due to the agents by which it is triggered. Given the wide use of these preparations in prehospital emergency medicine and intensive care treatment, physicians in other disciplines may also encounter MH.