Perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI Consensus

Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi, Antonio Corcione, Massimo Antonelli, Caterina Aurilio, Simonetta Baroncini, Michele Carron, Fernando Chiumiento, Gilda Cinnella, Ruggero Massimo Corso, Amedeo Costantini, Amato De MonteGiorgio Della Rocca, Giuseppe Doldo, Giulio Frova, Maurizio Fusari, Rosa Gallo, Antonino Giarratano, Arturo Guarino, Fabio Guarracino, Nicola Ladiana, Nicola Latronico, Alessandro Locatelli, Ottavia Manenti, Maurizio Menarini, Massimo Micaglio, Franco Pala, Salvatore Palermo, Vito A. Peduto, Paolo Pelaia, Tiziana Principi, Marco Rossi, Pasquale Sansone, Giuseppe Servillo, Maurizio Solca, Luigi Tritapepe, on behalf of the Obesity Task Force for the SIAARTI Airway Management Study Group

Research output: Contribution to journalReview article

Abstract

Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose Body Mass Index (BMI) is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population. Obesity is a multisystem, chronic, proinflammatory disorder. Unfortunately many countries are facing a marked increase in the obese population, defined as "globesity". Obesity presents an added risk in hospital, leading health care organizations to call for action to avoid adverse events and preventable complications. Periprocedural assessment and critical care strategies designed specifically for obese patients are crucial for reducing morbidity and mortality during surgery and in emergency settings, critical care and other particular settings (e.g., obstetrics). Specific care is needed for airway management, as are proactive strategies to reduce the risk of cardiovascular, endocrine, metabolic and infective complications; any effort can be fruitful, including special attention to the science of human factors. The Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) organized a consensus project involving other national scientific societies to increase risk awareness, define the best multidisciplinary approach for treating obese patients in election and emergency, and enable every hospital to provide appropriate levels of care and good clinical practices. The Obesity Project Task Force, a section of the SIAARTI Airway Management Study Group, used a formal consensus process to identify a series of notes, alerts and statements, to be adopted as bundles, to define appropriate clinical pathways for hospitalized obese patients. The consensus, approved by the Task Force and endorsed by several European scientific societies actively operating in this field, is presented herein.

Original languageEnglish
Pages (from-to)1314-1335
Number of pages22
JournalMinerva Anestesiologica
Volume82
Issue number12
Publication statusPublished - Dec 1 2016

Keywords

  • Clinical pathways
  • Critical care
  • Obesity
  • Patient safety
  • Perioperative care

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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