Childhood obesity: a challenge for the anaesthetist?

Abstract

The definition of childhood obesity has not been standardized in the past, making studies difficult to compare. In spite of this, the increase in the incidence of childhood obesity is evident and has now reached epidemic proportions. Obese children experience few of the medical complications seen in obese adults. Respiratory physiology appears to be most affected, the degree of which is determined by the level of obesity. Although there is a considerable amount of information on the anaesthetic management of the obese adult, very little has been written concerning the obese child. There is less pathology in the obese child when compared with the adult but some evidence shows a higher likelihood of a critical incident occurring when anaesthetizing such children. This shows that we need to be as worried about anaesthetizing the obese child as we are for the obese adult. This concern should increase with increasing body mass index.

Correction to: Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review

“…Obesity has become a challenge in pediatric anesthesia because the rates of pediatric overweight and obesity are rising [76,77]. Pediatric obesity is defined by a body mass index [95th percentile [78].…”

Pediatrik Hastaların Preoperatif Değerlendirmesi

“…Bu nedenle operasyon ve anestezi planı buna göre yapılmalı, öksürük, konjesyon, ateş gibi fizik muayene bulguları olan elektif cerrahiler 4-6 hafta ertelenmelidir [19]. [22]. Astım ve solunum yolu enfeksiyonları da daha sıktır.…”

“…Astım ve solunum yolu enfeksiyonları da daha sıktır. Hipertansiyon, gastroözofageal reflü, obstrüktif uyku apne sendromu gibi problemler de daha sık görülür [22,23]. Çocuklarda diyabet prevalansı obeziteyle paralel olarak artmaktadır [24].…”

An aid to drug dosing safety in obese children: development of a new nomogram and comparison with existing methods for estimation of ideal body weight and lean body mass

“…where ideal BMI (BMI 50 ) is the BMI value on the 50th centile of a UK BMI chart for the child's age and sex [4][5][6][7][8].…”

“…The validity of the measurement is transient and is lost as the child grows. An alternative mathematical estimate for LBM has been recommended, which makes use of the observation that a mean of 29% of the excess weight carried by an obese child is lean tissue [4,7,8]. This can be expressed as the equation:…”