Respiratory Concerns in the Obese Patient

Perioperative Anesthetic Care of the Obese Patient

Volumn , Issue , 2016, Pages 12-25

  Eikermann, Matthias ^a,b  

^a UNIVERSITY OF DUISBURG ESSEN   (Germany)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84859104538     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.3109/9781420095319-4     Document Type: Chapter

References (105)

1. Jackson BM, English SJ, Fairman RM, et al. Carotid artery stenting: identification of risk factors for poor outcomes. J Vasc Surg 2008; 48: 74-9.
2. Tait AR, Voepel-Lewis T, Burke C, et al. Incidence and risk factors for perioperative adverse respiratory events in children who are obese. Anesthesiology 2008; 108: 375-80.
3. Gendall KA, Raniga S, Kennedy R, et al. The impact of obesity on outcome after major colorectal surgery. Dis Colon Rectum 2007; 50: 2223-37.
4. Kucher N, Tapson VF, Goldhaber SZ. Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients. Thromb Haemost 2005; 93: 494-8.
5. Bamgbade OA, Rutter TW, Nafiu OO, et al. Postoperative complications in obese and nonobese patients. World J Surg 2007; 31: 556-60; discussion 561.
6. Malhotra A, Hillman D. Obesity and the lung: 3. Obesity, respiration and intensive care. Thorax 2008; 63: 925-31.
7. Forrest JB, Rehder K, Cahalan MK, et al. Multicenter study of general anesthesia. III. Predictors of severe perioperative adverse outcomes. Anesthesiology 1992; 76: 3-15.
8. Sjostrom L, Larsson B, Backman L, et al. Swedish obese subjects (SOS). Recruitment for an intervention study and a selected description of the obese state. Int J Obes Relat Metab Disord 1992; 16: 465-79.
9. Shnaider I, Chung F. Outcomes in day surgery. Curr Opin Anaesthesiol 2006; 19:622-9.
10. Swinburn CR, Cooper BG, Mould H, et al. Adverse effect of additional weight on exercise against gravity in patients with chronic obstructive airways disease. Thorax 1989; 44:716-20.
11. Sugerman HJ, Fairman RP, Sood RK, et al. Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 1992; 55: 597S-601S.
12. Thomas PS, Cowen ER, Hulands G, et al. Respiratory function in the morbidly obese before and after weight loss. Thorax 1989; 44: 382-6.
13. Schwab RJ, Gupta KB, Gefter WB, et al. Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 1995; 152: 1673-89.
14. Schwab RJ, Pasirstein M, Kaplan L, et al. Family aggregation of upper airway soft tissue structures in normal subjects and patients with sleep apnea. Am J Respir Crit Care Med 2006; 173: 453-63.
15. Thawley SE. Surgical treatment of obstructive sleep apnea. Med Clin North Am 1985; 69: 1337-58.
16. Carroll D. A peculiar type of cardiopulmonary failure associated with obesity. Am J Med 1956; 21: 819-24.
17. Bedell GN, Wilson WR, Seebohm PM. Pulmonary function in obese persons. J Clin Invest 1958; 37: 1049-60.
18. Rochester DF, Enson Y. Current concepts in the pathogenesis of the obesity-hypoventilation syndrome. Mechanical and circulatory factors. Am J Med 1974; 57: 402-20.
19. Leech J, Onal E, Aronson R, et al. Voluntary hyperventilation in obesity hypoventilation. Chest 1991; 100: 1334-8.
20. Zwillich CW, Sutton FD, Pierson DJ, et al. Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome. Am J Med 1975; 59: 343-8.
21. Pedersen J, Torp-Pedersen E. Ventilatory insufficiency in extreme obesity. Acta Med Scand 1960; 167: 343-52.
22. Naimark A, Cherniack RM. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol 1960; 15: 377-82.
23. Luce JM. Respiratory complications of obesity. Chest 1980; 78: 626-31.
24. Lazarus R, Sparrow D, Weiss ST. Effects of obesity and fat distribution on ventilatory function: the normative aging study. Chest 1997; 111: 891-8.
25. Remmers JE, Marttila I. Action of intercostal muscle afferents on the respiratory rhythm of anesthetized cats. Respir Physiol 1975; 24: 31-41.
26. Wadstrom C, Muller-Suur R, Backman L. Influence of excessive weight loss on respiratory function. A study of obese patients following gastroplasty. Eur J Surg 1991; 157:341-6.
27. Robertson CH Jr, Pagel MA, Johnson RL Jr. The distribution of blood flow, oxygen consumption, and work output among the respiratory muscles during unobstructed hyperventilation. J Clin Invest 1977; 59: 43-50.
28. Fritts HW Jr, Filler J, Fishman AP, et al. The efficiency of ventilation during voluntary hyperpnea: studies in normal subjects and in dyspneic patients with either chronic pulmonary emphysema or obesity. J Clin Invest 1959; 38: 1339-48.
29. Kress JP, Pohlman AS, Alverdy J, et al. The impact of morbid obesity on oxygen cost of breathing (VO(2RESP)) at rest. Am J Respir Crit Care Med 1999; 160: 883-6.
30. Sharp JT, Henry JP, Sweany SK, et al. Effects of mass loading the respiratory system in man. J Appl Physiol 1964; 19: 959-66.
31. Sampson MG, Grassino K. Neuromechanical properties in obese patients during carbon dioxide rebreathing. Am J Med 1983; 75: 81-90.
32. Weiner P, Waizman J, Weiner M, et al. Influence of excessive weight loss after gastroplasty for morbid obesity on respiratory muscle performance. Thorax 1998; 53:39-42.
33. Holley HS, Milic-Emili J, Becklake MR, et al. Regional distribution of pulmonary ventilation and perfusion in obesity. J Clin Invest 1967; 46: 475-81.
34. Pelosi P, Croci M, Ravagnan I, et al. Total respiratory system, lung, and chest wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest 1996; 109: 144-51.
35. McClean KM, Kee F, Young IS, et al. Obesity and the lung: 1. Epidemiology. Thorax 2008; 63: 649-54.
36. Beuther DA, Sutherland ER. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med 2007; 175: 661-6.
37. Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest 2006; 130: 827-33.
38. Shore SA. Obesity and asthma: implications for treatment. Curr Opin Pulm Med 2007; 13: 56-62.
39. Leslie WS, Hankey CR, Lean ME. Weight gain as an adverse effect of some commonly prescribed drugs: a systematic review. QJM 2007; 100: 395-404.
40. Welch KC, Foster GD, Ritter CT, et al. A novel volumetric magnetic resonance imaging paradigm to study upper airway anatomy. Sleep 2002; 25: 532-42.
41. Isono S, Remmers JE, Tanaka A, et al. Anatomy of pharynx in patients with obstructive sleep apnea and in normal subjects. J Appl Physiol 1997; 82: 1319-26.
42. Watanabe T, Isono S, Tanaka A, et al. Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing. Am J Respir Crit Care Med 2002; 165: 260-5.
43. Isono S, Isono S, Tanaka A, et al. Anatomy of pharynx in patients with sleep-disordered breathing. J Appl Physiol 2002; 82: 260-5.
44. Schwartz AR, Patil SP, Laffan AM, et al. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc 2008; 5: 185-92.
45. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-43.
46. Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-5.
47. Eikermann M, Jordan AS, Chamberlin NL, et al. The influence of aging on pharyngeal collapsibility during sleep. Chest 2007; 131: 1702-9.
48. Shinohara E, Kihara S, Yamashita S, et al. Visceral fat accumulation as an important risk factor for obstructive sleep apnoea syndrome in obese subjects. J Intern Med 1997; 241: 11-18.
49. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-39.
50. Schwartz AR, Gold AR, Schubert N, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991; 144: 494-8.
51. Peiser J, Lavie P, Ovnat A, et al. Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery. Ann Surg 1984; 199: 112-15.
52. Sundquist J, Li X, Friberg D, et al. Obstructive sleep apnea syndrome in siblings: an 8-year Swedish follow-up study. Sleep 2008; 31: 817-23.
53. Dempsey JA, Skatrud JB, Jacques AJ, et al. Anatomic determinants of sleep-disordered breathing across the spectrum of clinical and nonclinical male subjects. Chest 2002; 122:840-51.
54. Sauerland EK, Mitchell SP. Electromyographic activity of the human Genioglossus muscle in response to respiration and to positional changes of the head. Bull Los Angeles Neurol Soc 1970; 35: 69-73.
55. Chamberlin NL, Eikermann M, Fassbender P, et al. Genioglossus premotoneurons and the negative pressure reflex in rats. J Physiol 2007; 579: 515-26.
56. Horner RL, Innes JA, Holden HB, et al. Afferent pathway(s) for pharyngeal dilator reflex to negative pressure in man: a study using upper airway anaesthesia. J Physiol 1991; 436: 31-44.
57. van Lunteren E. Muscles of the pharynx: structural and contractile properties. Ear Nose Throat J 1993; 72: 27-9, 33.
58. Orem J. The nature of the wakefulness stimulus for breathing. Respir Physiol 2000; 119:113-21.
59. Mezzanotte WS, Tangel DJ, White DP. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J Clin Invest 1992; 89: 1571-9.
60. Horner RL, Innes JA, Morrell MJ, et al. The effect of sleep on reflex genioglossus muscle activation by stimuli of negative airway pressure in humans. J Physiol 1994; 476:141-51.
61. Wheatley JR, Tangel DJ, Mezzanotte WS, et al. Influence of sleep on response to negative airway pressure of tensor palatini muscle and retropalatal airway. J Appl Physiol 1993; 75: 2117-24.
62. Lo YL, Jordan AS, Malhotra A, et al. Influence of wakefulness on pharyngeal airway muscle activity. Thorax 2007; 62: 799-805.
63. Badr MS, Skatrud JB, Dempsey JA. Effect of chemoreceptor stimulation and inhibition on total pulmonary resistance in humans during NREM sleep. J Appl Physiol 1994; 76:1682-92.
64. Badr MS, Toiber F, Skatrud JB, et al. Pharyngeal narrowing/occlusion during central sleep apnea. J Appl Physiol 1995; 78: 1806-15.
65. Warner G, Skatrud JB, Dempsey JA. Effect of hypoxia-induced periodic breathing on upper airway obstruction during sleep. J Appl Physiol 1987; 62: 2201-11.
66. Ibrahim LH, Patel SR, Modarres M, et al. A measure of ventilatory variability at wake-sleep transition predicts sleep apnea severity. Chest 2008; 134: 73-8.
67. Van de Graaff WB. Thoracic influence on upper airway patency. J Appl Physiol 1988; 65: 2124-31.
68. Stanchina ML, Malhotra A, Fogel RB, et al. The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleep. Sleep 2003; 26: 851-6.
69. Ballard RD, Irvin CG, Martin RJ, et al. Influence of sleep on lung volume in asthmatic patients and normal subjects. J Appl Physiol 1990; 68: 2034-41.
70. Kingshott RN, Sime PJ, Engleman HM, et al. Self assessment of daytime sleepiness:patient versus partner. Thorax 1995; 50: 994-5.
71. Lugaresi E, Cirignotta F, Coccagna G, et al. Some epidemiological data on snoring and cardiocirculatory disturbances. Sleep 1980; 3: 221-4.
72. Gottlieb DJ, Yao Q, Redline S, et al. Does snoring predict sleepiness independently of apnea and hypopnea frequency? Am J Respir Crit Care Med 2000; 162: 1512-17.
73. Deegan PC, McNicholas WT. Predictive value of clinical features for the obstructive sleep apnoea syndrome. Eur Respir J 1996; 9: 117-24.
74. Doherty LS, Kiely JL, Swan V, et al. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005; 127: 2076-84.
75. Nuckton TJ, Glidden DV, Browner WS, et al. Physical examination: mallampati score as an independent predictor of obstructive sleep apnea. Sleep 2006; 29: 903-8.
76. Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men. Thorax 1991; 46: 85-90.
77. Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008; 108: 812-21.
78. Sullivan CE, Berthon-Jones M, Issa FG. Remission of severe obesity-hypoventilation syndrome after short-term treatment during sleep with nasal continuous positive airway pressure. Am Rev Respir Dis 1983; 128: 177-81.
79. Kakkar RK, Berry RB. Positive airway pressure treatment for obstructive sleep apnea. Chest 2007; 132: 1057-72.
80. Won CH, Li KK, Guilleminault C. Surgical treatment of obstructive sleep apnoea in adults. Bmj 2008; 5: 44-5.
81. Carley DW, Olopade C, Ruigt GS, et al. Efficacy of mirtazapine in obstructive sleep apnea syndrome. Sleep 2007; 30: 35-41.
82. Heinzer RC, White DP, Jordan AS, et al. Trazodone increases arousal threshold in obstructive sleep apnoea. Eur Respir J 2008; 31: 1308-12.
83. Younes M, Park E, Horner RL. Pentobarbital sedation increases genioglossus respiratory activity in sleeping rats. Sleep 2007; 30: 478-88.
84. Younes M. Role of arousals in the pathogenesis of obstructive sleep apnea. Am J Respir Crit Care Med 2004; 169: 623-33.
85. Wellman A, Malhotra A, Jordan AS, et al. Chemical control stability in the elderly. J Physiol 2007; 581: 291-8.
86. Berry RB, Kouchi K, Bower J, et al. Triazolam in patients with obstructive sleep apnea. Am J Respir Crit Care Med 1995; 151: 450-4.
87. Hwang D, Shakir N, Limann B, et al. Association of sleep-disordered breathing with postoperative complications. Chest 2008; 133: 1128-34.
88. Ahmad S, Nagle A, McCarthy RJ, et al. Postoperative hypoxemia in morbidly obese patients with and without obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesth Analg 2008; 107: 138-43.
89. Eikermann MKJ, Dennehy K, Ortiz V, et al. Is obstructive sleep apnea a risk factor for difficult airway anatomy and desaturation? Anesthesiology 2008; 109: A227.
90. Hwang JC, St John WM, Bartlett D Jr. Respiratory-related hypoglossal nerve activity:influence of anesthetics. J Appl Physiol 1983; 55: 785-92.
91. Drummond GB. Influence of thiopentone on upper airway muscles. Br J Anaesth 1989; 63: 12-21.
92. Eastwood PR, Szollosi I, Platt PR, et al. Collapsibility of the upper airway during anesthesia with isoflurane. Anesthesiology 2002; 97: 786-93.
93. Eastwood PR, Platt PR, Shepherd K, et al. Collapsibility of the upper airway at different concentrations of propofol anesthesia. Anesthesiology 2005; 103: 470-7.
94. Norton JR, Ward DS, Karan S, et al. Differences between midazolam and propofol sedation on upper airway collapsibility using dynamic negative airway pressure. Anesthesiology 2006; 104: 1155-64.
95. Eikermann M, Vogt FM, Herbstreit F, et al. The predisposition to inspiratory upper airway collapse during partial neuromuscular blockade. Am J Respir Crit Care Med 2007; 175: 9-15.
96. Isono S, Tanaka A, Nishino T. Lateral position decreases collapsibility of the passive pharynx in patients with obstructive sleep apnea. Anesthesiology 2002; 97: 780-5.
97. Knill RL, Moote CA, Skinner MI, et al. Anesthesia with abdominal surgery leads to intense REM sleep during the first postoperative week. Anesthesiology 1990; 73: 52-61.
98. Chung F, Yegneswaran B, Liao P, et al. Validation of the Berlin questionnaire and American Society of Anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology 2008; 108: 822-30.
99. Gupta RM, Parvizi J, Hanssen AD, et al. Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case-control study. Mayo Clin Proc 2001; 76: 897-905.
100. O’Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg 2004; 14: 23-6.
101. Zgleszewski SE, Zurakowski D, Fontaine PJ, et al. Is propofol a safe alternative to pentobarbital for sedation during pediatric diagnostic CT? Radiology 2008; 247: 528-34.
102. Eikermann MFP, Malhotra A, Jordan AS, et al. Differential effects of isoflurane and propofol on genioglossus muscle function and breathing. Anesthesiology 2008; 108:897-906.
103. Meoli AL, Rosen CL, Kristo D, et al. Upper airway management of the adult patient with obstructive sleep apnea in the perioperative period-avoiding complications. Sleep 2003; 26: 1060-5.
104. Gross JB, Bachenberg KL, Benumof JL, et al. Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea. Anesthesiology 2006; 104: 1081-93; quiz 1117-18.
105. Lin CC. Effect of nasal CPAP on ventilatory drive in normocapnic and hypercapnic patients with obstructive sleep apnoea syndrome. Eur Respir J 1994; 7: 2005-10.