Università degli studi di Modena e Reggio Emilia

Università degli Studi di Modena e Reggio Emilia
Corso di laurea in infermieristica - Sede di Modena

Abstract

In the last few years, obesity is increasing worldwide, specially in wemen than men. Therefore the number of overweight and obese patient is also growing in hospitals and intensive care units. 
The aim of this thesis is to verify the information inside literature about management of the obese patient in intensive care unit, in particular for some more complicated caring aspects. One of these is drug consumption: drug must be dosed differently in obese patients than in normal weight patient, in obesity the percentage of adipose and lean tissue is different than in normal weight. This imbalance leads to an altered drugs absorption and distribution, and finally caused an insufficient peak serum drug. Another problem concerns airway management: accumulation of fat in pharyngeal and abdominal area may compromise ventilation and make it difficult ventilation. In the obese patient oxygen consumption is also increased at rest. With regard to nutrition, the obese subject in intensive care unit needs a low-calorie nutritional therapy with high protein content, to avoid muscle catabolism. Finally, all would think of the worst outcomes of obese subjects, while studies show a phenomenon called "Obesity Survival Paradox": although in obese patients the length of stay in intensive care unit and the time of intubation is longer than normal weight patient, is seems the first to survive longer than the second. Indeed, only obesity does not constitute a factor that increase mortality rate, but the diseases associated with it can constitute a risk.