Emergencies in obese patients: a narrative review

Abstract

Obesity is associated to an increased risk of morbidity and mortality due to respiratory, cardiovascular, metabolic, and neoplastic diseases. The aim of this narrative review is to assess the physio-pathological characteristics of obese patients and how they influence the clinical approach during different emergency settings, including cardiopulmonary resuscitation. A literature search for published manuscripts regarding emergency and obesity across MEDLINE, EMBASE, and Cochrane Central was performed including records till January 1, 2021. Increasing incidence of obesity causes growth in emergency maneuvers dealing with airway management, vascular accesses, and drug treatment due to both pharmacokinetic and pharmacodynamic alterations. Furthermore, instrumental diagnostics and in/out-hospital transport may represent further pitfalls. Therefore, people with severe obesity may be seriously disadvantaged in emergency health care settings, and this condition is enhanced during the COVID-19 pandemic, when obesity was stated as one of the most frequent comorbidity. Emergency in critical obese patients turns out to be an intellectual, procedural, and technical challenge. Organization and anticipation based on the understanding of the physiopathology related to obesity are very important for the physician to be mentally and physically ready to face the associated issues.

SOBA UK response to “emergencies in obese patients: a narrative review”

“…The letter supports the authors of the review and agrees with the need for improved guidance and organisational preparedness in this field Dear Editor, SOBA UK read this article with interest and welcome the review of managing patients with obesity in the emergency setting [1].…”

Emergency in obese patients: a reply to SOBA UK

“…We read with interest and really appreciated the comments by Dr Mckechnie and colleagues [ 1 ] on our recent review [ 2 ]. We believe that the most important issue raised by our colleagues’ letter is the ubiquitous attention to obesity, and its implications for perioperative and emergency care.…”