University of Florida, Jacksonville, FL
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Miscellaneous Critical Care
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
PURPOSE: The percentage of the United States population with a BMI >50 kg/m2 has increased more than 10-fold between 2000 and 2010. However morbidity and mortality associated with the severity of obesity in the critically ill has remained controversial. We aimed to compare characteristics and outcomes in severe obese and super obese patients with acute respiratory distress syndrome (ARDS).
METHODS: We performed a retrospective chart review of critically ill patients with a BMI ≥ 30 and with a diagnosis of ARDS during their hospital stay.
RESULTS: At the time of this abstract we had reviewed 30 patients with average BMI of 42.7 ± 12.2. The average age was 52.1 years (25-78 years) and 50% were males. There were 18 (60%) moderately obese patients with BMI ≥ 30 and <40 and 12 (40%) super obese patients with a BMI ≥ 40. Super obese patients more frequently underwent prone positioning (41.7% vs 27.8 %) and required paralytics (41.7% vs 38.9%). Multi-organ failure was less common among super obese patients n=7 (58.3%) compared to moderately obese patients, n=15 (83.3%). Similarly acute kidney injury requiring hemodialysis was observed in 4 (33.3%) of the super obese patients compared to 7 (38.9%) in moderately obese patients. Tracheostomies were more common among super obese (n=5, 41.7%) compared to moderately obese (n=7, 38.9%). Survival to discharge was 50% among moderately obese compared to 33% among super obese patients.
CONCLUSIONS: Super obese patients with ARDS appeared to be less likely to have multi-organ failure but had lower survival to discharge compared to moderately obese patients.
CLINICAL IMPLICATIONS: Larger studies are needed to study the impact of super obesity on critical illness outcomes.
DISCLOSURE: The following authors have nothing to disclose: Ena Gupta, pujan patel, Amit Babbar, Kasey Treger, Marium Louis, Lisa Jones, Vandana Seeram, James Cury, Abubakr Bajwa
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