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Perioperative management of the obese surgical patient.

ABSTRACT: The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered.After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered.There were no controversies regarding preoperative management and the intraoperative care of the obese surgical patient.Is there a healthy obese state that gives rise to the obesity paradox regarding postoperative complications?This review considers how to prepare for and manage the obese surgical patient through the entire spectrum, from preoperative assessment to possible postoperative intensive care.What results in an obese patient developing 'unhealthy' obesity?

SUBMITTER: Lang LH

PROVIDER: S-EPMC5862330 | biostudies-other | 2017 Dec

REPOSITORIES: biostudies-other

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Perioperative management of the obese surgical patient.

Lang L H LH Parekh K K Tsui B Y K BYK Maze M M

British medical bulletin 20171201 1

<h4>Introduction</h4>The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered.<h4>Sources of data</h4>After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered.<h4>Areas of agreement</h4>There were no controversies regarding preoperative management and the int ...[more]

PMID: 29140418

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Project description:BackgroundBody temperature is tightly regulated with hormonal and cellular metabolism for normal functioning; however perioperative hypothermia is common secondary to anesthesia and surgical exposure.Prevention and maintaining body temperature should be started 1-2hrs before induction of anesthesia, to do this both active and passive warming system are effective to prevent complications associated with perioperative hypothermia.MethodsThe aim of this systematic review is to develop a clear clinical practice protocol in prevention and management of perioperative hypothermia for elective adult surgical patients.The study is conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline 2020. After formulating clear criteria for the evidences to be included an appropriate method of searching was conducted by using the Pub Med, Google scholar and Cochrane library using the following MeSH terms: (inadvertent hypothermia AND anesthesia, hypothermia AND perioperative management and thermoregulation AND anesthesia) were used to draw evidences.After a reasonable amount of evidences were collected, appraisal and evaluation of study quality was based on WHO 2011 level of evidence and degree of recommendation. Final conclusions and recommendations are done by balancing the benefits and downsides of alternative management strategies for perioperative management of hypothermia.This systematic review registered with research registry unique identifying number (UIN) of "reviewregistry1253" in addition the overall AMSTAR 2 quality of this systematic review is moderate level.DiscussionPreserving a patient's body temperature during anesthesia and surgery is to minimize heat loss by reducing radiation and convection from the skin, evaporation from exposed surgical areas, and cooling caused by the introduction of cold intravenous fluids.ConclusionHypothermia is least monitored complication during anesthesia and surgery results cardiac abnormalities, impaired wound healing, increased surgical site infections, shivering and delayed postoperative recovery, and coagulopathies.

Dataset Information

Perioperative management of the obese surgical patient.

Publications

Perioperative management of the obese surgical patient.

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