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Author Weig, Thomas ♦ Janitza, Silke ♦ Zoller, Michael ♦ Dolch, Michael E. ♦ Miller, Jens ♦ Frey, Lorenz ♦ Kneidinger, Nikolaus ♦ Johnson, Thorsten ♦ Schubert, Mirjam I. ♦ Irlbeck, Michael
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Digestive System Diseases ♦ Respiratory Tract Diseases ♦ Male Urogenital Diseases ♦ Nutritional and Metabolic Diseases ♦ Diseases ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Physical Phenomena ♦ Musculoskeletal and Neural Physiological Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Obesity, Abdominal ♦ Complications ♦ Patient Positioning ♦ Prone Position ♦ Respiratory Distress Syndrome, Adult ♦ Mortality ♦ Therapy ♦ Adult ♦ Female ♦ Hepatitis ♦ Etiology ♦ Humans ♦ Intensive Care Units ♦ Length Of Stay ♦ Male ♦ Middle Aged ♦ Renal Insufficiency ♦ Retrospective Studies ♦ Statistics, Nonparametric ♦ Time Factors ♦ Journal Article
Abstract PURPOSE: Obesity is a worldwide pandemic, and obese patients face an increased risk of developing acute respiratory distress syndrome (ARDS). Prone positioning (PP) is a frequently used intervention in the treatment of ARDS. There are no data describing the impact of PP on morbidity and mortality in abdominally obese patients. We report our observations in abdominally obese ARDS patients treated with PP. MATERIALS AND METHODS: Patients with ARDS (n=82) were retrospectively divided into 2 groups characterized by presence (n=41) or absence (n=41) of abdominal obesity as defined by a sagittal abdominal diameter of 26 cm or more. RESULTS: There was no difference in cumulative time abdominally obese patients were placed in prone position from admission to day 7 (41.0 hours [interquartile range, 50.5 hours] vs 39.5 hours [interquartile range, 61.5 hours]; P=.65) or in overall intensive care unit mortality (34% vs 34%; P=1). However, abdominally obese patients developed renal failure (83% vs 35%; P<.001) and hypoxic hepatitis (22% vs 2%; P=.015) more frequently. A significant interaction effect between abdominal obesity and prone position with respect to mortality risk (likelihood ratio, P=.0004) was seen if abdominally obese patients were treated with prolonged cumulative PP. CONCLUSION: A cautious approach to PP should be considered in abdominally obese patients.
Description Author Affiliation: Weig T ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany. Electronic address: tweig@med.lmu.de.); Janitza S ( Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Zoller M ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Dolch ME ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Miller J ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Frey L ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Kneidinger N ( Department of Internal Medicine V, Comprehensive Pulmonary Center, Member of the German Center for Lung Research, Ludwig-Maximilians-University, 81377 Munich, Germany.); Johnson T ( Department of Clinical Radiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Schubert MI ( Department of Clinical Radiology, Ludwig-Maximilians-University, 81377 Munich, Germany.); Irlbeck M ( Department of Anaesthesiology, Ludwig-Maximilians-University, 81377 Munich, Germany.)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2014-08-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 29
Issue Number 4


Source: WHO-Global Index Medicus