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

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

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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.
Lingua originaleEnglish
pagine (da-a)1314-1335
Numero di pagine22
RivistaMinerva Anestesiologica
Volume82
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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    Giarratano, A., Sorbello, M., Corso, R. M., Menarini, M., Principi, T., Carron, M., Guarino, A., Donato, P., Pala, F., Manenti, O., Guarracino, F., Sansone, P., Fusari, M., Trolio, A., Rossi, M., Esposito, C., Servillo, G., Gallo, R., Rocca, G. D., ... Di Giacinto, I. (2016). Perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI Consensus. Minerva Anestesiologica, 82, 1314-1335.