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Obezite ve Yoğun Bakım

Yıl 2012, Cilt: 16 Sayı: 2, 69 - 75, 31.12.2014

Neriman Zengin

Öz

Genetik ve çevresel faktörlerin etkisi ile gelişen obezite hem kilo hem de metabolik değişimi
içeren bir sendromdur. Vücutta meydana getirdiği patofizyolojik değişiklikler genel olarak fizyolojik,
proinflamatuvar ve kilo ile ilgili olmak üzere üç grupta toplanır. Obezite prevalansı artış gösteren
önemli bir halk sağlığı sorunudur. Prevelansındaki artışla birlikte ilerleyen yıllarda yoğun
bakıma kabul edilen hastalar arasında obezite oranı artacaktır. Obezitenin tüm sistemler üzerine
olumsuz etkileri yoğun bakım süreci ile birleştiğinde hastanede ve mekanik ventilasyonda kalma sü-
resinde uzama, enfeksiyon riskinde artma, yara iyileşmesinde gecikme, bası yaraları, en sık karşılaşılan sorunlardır. Ayrıca solunum, dolaşım, endokrin, gastrointestinal, kas iskelet ve üriner sistem
üzerinde de birçok olumsuz etkileri görülmektedir. Tüm bu sorunlar ise ölüm riskini arttırmaktadır.
Yoğun bakım ünitesinde obez hastaların tedavi ve bakımında öncelikle obezitenin vücut sistemleri
üzerine etkisi bilinmelidir. Bu yazıda obezitenin sistemler üzerine olumsuz etkileri ve yoğun
bakım süreci incelenmiştir

Anahtar Kelimeler

Mekanik ventilasyon obezite

Kaynakça

  • 1.Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü Türkiye Obezite Ile Mücadele ve Kontrol Programı (2010-2014) Ankara, 2010.
  • 2. Yalçın A, Kaya A. Obesite ve yoğun bakım. Turkiye Klinikleri Arch Lung 2012;13(Suppl):14-22.
  • 3. Obesity and overweight. Updated March 2013. http://www.who.int/mediacentre/factsheets/fs311/en/
  • 4. May AL, Freedman D, Sherry B, Blanck HM. Centers for Disease Control and Prevention(CDC) Obesity-United States, 1999-2010. MMWR Surveill Summ 2013;22(62) Suppl 3:120-8.
  • 5. Health at a Glance Europe 2012. OECD (2012), Health at a Glance: Europe 2012,OECD Publishing. http://dx.doi.org/10.1787/ 9789264183896-en.
  • 6. Amundson DE, Djurkovic S, Matwiyoff GN. The obesity paradox. Crit Care Clin 2010;26(4):583-96.
  • 7. Honiden S,McArdle JR. Obesity in the intensive care unit. Clin Chest Med 2009;30(3):581-99.
  • 8. Lisboa T, Rello J, Richart C, Anzueto A, El solh AE. Obesity and critical care. Clinical Pulmonary medicine 2009;16(4):202-11. 9. Ray DE, Matchett SC, Baker K, Wasser T, Young MJ. The effect of body mass index on patient outcomes in a medical ICU. Chest 2005;127(6):2125-31.
  • 10. Sakr Y, Madl C, Filipescu D, Moreno R,Groeneveld J, Artigas A, et al. Obesity is associated with increased morbidity but not mortality in critically ill patients. Intensive Care Med 2008;34 (11):1999-2009.
  • 11. Akinnusi ME, Pineda LA, El Solh AA. Effect of obesity on intensive care morbidity and mortality: a meta-analysis. Crit Care Med 2008;36(1):151-8.
  • 12. Bercault N, Boulain T, Kuteifan K, Wolf M,Runge I, Fleury JC. Obesity-related excess mortality rate in an adult intensive care unit: A risk-adjusted matched cohort study. Crit Care Med 2004;32(4):998-1003.
  • 13. Nasraway SA Jr, Albert M, Donnelly AM, Ruthazer R, Shikora SA, Saltzman E. Morbid obesity is an independent determinant of death among surgical critically ill patients. Crit Care Med 2006;34(4):964-70.
  • 14. Alban RF, Lyass S, Margulies DR, Shabot MM. Obesity does not affect mortality after trauma. Am Surg 2006;72(10):966-9.
  • 15. O’Brien JM, Phillips GS, Ali NA, Lucarelli M, Marsh CB, Lemeshow S. Body mass index is independently associated with hospital mortality in mechanically ventilated adults with acute lung injury. Crit Care Med 2006; 34(3): 738-44.
  • 16. Hogue CW Jr, Stearns JD, Colantuoni E, Robinson KA, Stierer T, Mitter N, et al. The impact of obesity on outcomes after critical illness: a meta-analysis. Intensive Care Med 2009;35(7):1152-70.
  • 17. Miehsler W. Mortality, morbidity and special issues of obese ICU patients. Wien Med Wochenschr 2010;160(5-6):124-8.
  • 18. Charlebois D, Wilmoth D. Critical care of patients with obesity. Crit Care Nure 2004;24(4)19-27.
  • 19. Lewandowski K, Lewandowski M. Intensive care in the obese. Best Pract Res Clin Anaesthesiol 2011;25(1):95-108.
  • 20. Ashburn DD, DeAntonio A, Reed MJ. Pulmonary system and obesity. Crit Care Clin 2010;26(4):597-602.
  • 21. Malhotra A, Hillman D. Obesity and the lung:3 Obesity, respiration and intensive care. Thorax 2008;63(10):925-31.
  • 22. Taggart HM, Mincer AB, Thompson AW. Caring for the orthopaedic patient who is obese. Orthop Nurs 2004;23(3):204-10.
  • 23. Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure. JACC Heart Fail 2013;1(2):93-102.
  • 24. Alpert MA, Agrawal H, Aggarwal K, Kumar SA,Kumar A. Heart failure and obesity in adults: pathophysiology, clinical manifestations and management. Curr Heart Fail Rep 2014; 11(2):156-65.
  • 25. Markoff B, Amsterdam A. Impact of obesity on hospitalized patients. Mt Sinai J Med 2008;75(5):454-9.
  • 26. Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000;85(1):91-108.
  • 27. McAtee M, Personett RJ. Obesity-related risks and prevention strategies for critically ill adults.Crit Care Nurs Clin North Am 2009;21(3):391-401.
  • 28. García-García ML, Campillo-Soto A, MartínLorenzo JG, Torralba-Martínez JA, Lirón-Ruiz R, Aguayo-Albasini JL. Bariatric surgery, a risk factor for rhabdomyolysis. Rev Esp Anestesiol Reanim 2013;60(9):535-7.
  • 29. Hall JE, Henegar JR, Dwyer TM, Liu J, Da Silva AA, Kuo JJ, et al. Is obesity a major cause of chronic kidney disease? Adv Ren Replace Ther 2004;11(1):41-54.
  • 30. Bamgbade OA, Rutter TW, Nafiu OO, Dorje P. Postoperative complications in obese and nonobese patients. World J Surg 2007; 31(3):556-60.
  • 31. Rivera-Gonzalez G, Shook B, Horsley V. Adipocytes in skin health and disease. Cold Spring H Harb Perspect Med 2014;4(3).

Obesity and Intensive Care

Yıl 2012, Cilt: 16 Sayı: 2, 69 - 75, 31.12.2014

Neriman Zengin

Öz

 Obesity, resulting from genetic and environmental factors, is a syndrome that combines
both weight gain and metabolic alterations. The pathologic physiology changes caused in the body
by obesity are generally attributable to one of these three groups of conditions: physiological, proinflammatory
and weight gain. Obesity represents a major public health problem; its prevalence is
increasing. Such an increased prevalence will increase the ratio of future obese patients admitted
to intensive care units (ICU). The combination of the effects of obesity on all body systems and of
the intensive care procedures results most often in increased hospitalization and mechanical ventilation
duration, increased risk of infection, delayed wound healing and increased pressure sores.
Many other untoward effects on the respiratory, cardiovascular, endocrine, gastrointestinal, musculoskeletal
and urinary systems are also observed. All these problems together increase mortality.
When caring for obese patients in the ICU, knowing the effects of obesity on body systems is a priority.
This article examines the adverse effects of obesity on body systems and intensive care

Anahtar Kelimeler

Intensive care unit mechanical ventilation

Kaynakça

  • 1.Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü Türkiye Obezite Ile Mücadele ve Kontrol Programı (2010-2014) Ankara, 2010.
  • 2. Yalçın A, Kaya A. Obesite ve yoğun bakım. Turkiye Klinikleri Arch Lung 2012;13(Suppl):14-22.
  • 3. Obesity and overweight. Updated March 2013. http://www.who.int/mediacentre/factsheets/fs311/en/
  • 4. May AL, Freedman D, Sherry B, Blanck HM. Centers for Disease Control and Prevention(CDC) Obesity-United States, 1999-2010. MMWR Surveill Summ 2013;22(62) Suppl 3:120-8.
  • 5. Health at a Glance Europe 2012. OECD (2012), Health at a Glance: Europe 2012,OECD Publishing. http://dx.doi.org/10.1787/ 9789264183896-en.
  • 6. Amundson DE, Djurkovic S, Matwiyoff GN. The obesity paradox. Crit Care Clin 2010;26(4):583-96.
  • 7. Honiden S,McArdle JR. Obesity in the intensive care unit. Clin Chest Med 2009;30(3):581-99.
  • 8. Lisboa T, Rello J, Richart C, Anzueto A, El solh AE. Obesity and critical care. Clinical Pulmonary medicine 2009;16(4):202-11. 9. Ray DE, Matchett SC, Baker K, Wasser T, Young MJ. The effect of body mass index on patient outcomes in a medical ICU. Chest 2005;127(6):2125-31.
  • 10. Sakr Y, Madl C, Filipescu D, Moreno R,Groeneveld J, Artigas A, et al. Obesity is associated with increased morbidity but not mortality in critically ill patients. Intensive Care Med 2008;34 (11):1999-2009.
  • 11. Akinnusi ME, Pineda LA, El Solh AA. Effect of obesity on intensive care morbidity and mortality: a meta-analysis. Crit Care Med 2008;36(1):151-8.
  • 12. Bercault N, Boulain T, Kuteifan K, Wolf M,Runge I, Fleury JC. Obesity-related excess mortality rate in an adult intensive care unit: A risk-adjusted matched cohort study. Crit Care Med 2004;32(4):998-1003.
  • 13. Nasraway SA Jr, Albert M, Donnelly AM, Ruthazer R, Shikora SA, Saltzman E. Morbid obesity is an independent determinant of death among surgical critically ill patients. Crit Care Med 2006;34(4):964-70.
  • 14. Alban RF, Lyass S, Margulies DR, Shabot MM. Obesity does not affect mortality after trauma. Am Surg 2006;72(10):966-9.
  • 15. O’Brien JM, Phillips GS, Ali NA, Lucarelli M, Marsh CB, Lemeshow S. Body mass index is independently associated with hospital mortality in mechanically ventilated adults with acute lung injury. Crit Care Med 2006; 34(3): 738-44.
  • 16. Hogue CW Jr, Stearns JD, Colantuoni E, Robinson KA, Stierer T, Mitter N, et al. The impact of obesity on outcomes after critical illness: a meta-analysis. Intensive Care Med 2009;35(7):1152-70.
  • 17. Miehsler W. Mortality, morbidity and special issues of obese ICU patients. Wien Med Wochenschr 2010;160(5-6):124-8.
  • 18. Charlebois D, Wilmoth D. Critical care of patients with obesity. Crit Care Nure 2004;24(4)19-27.
  • 19. Lewandowski K, Lewandowski M. Intensive care in the obese. Best Pract Res Clin Anaesthesiol 2011;25(1):95-108.
  • 20. Ashburn DD, DeAntonio A, Reed MJ. Pulmonary system and obesity. Crit Care Clin 2010;26(4):597-602.
  • 21. Malhotra A, Hillman D. Obesity and the lung:3 Obesity, respiration and intensive care. Thorax 2008;63(10):925-31.
  • 22. Taggart HM, Mincer AB, Thompson AW. Caring for the orthopaedic patient who is obese. Orthop Nurs 2004;23(3):204-10.
  • 23. Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure. JACC Heart Fail 2013;1(2):93-102.
  • 24. Alpert MA, Agrawal H, Aggarwal K, Kumar SA,Kumar A. Heart failure and obesity in adults: pathophysiology, clinical manifestations and management. Curr Heart Fail Rep 2014; 11(2):156-65.
  • 25. Markoff B, Amsterdam A. Impact of obesity on hospitalized patients. Mt Sinai J Med 2008;75(5):454-9.
  • 26. Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000;85(1):91-108.
  • 27. McAtee M, Personett RJ. Obesity-related risks and prevention strategies for critically ill adults.Crit Care Nurs Clin North Am 2009;21(3):391-401.
  • 28. García-García ML, Campillo-Soto A, MartínLorenzo JG, Torralba-Martínez JA, Lirón-Ruiz R, Aguayo-Albasini JL. Bariatric surgery, a risk factor for rhabdomyolysis. Rev Esp Anestesiol Reanim 2013;60(9):535-7.
  • 29. Hall JE, Henegar JR, Dwyer TM, Liu J, Da Silva AA, Kuo JJ, et al. Is obesity a major cause of chronic kidney disease? Adv Ren Replace Ther 2004;11(1):41-54.
  • 30. Bamgbade OA, Rutter TW, Nafiu OO, Dorje P. Postoperative complications in obese and nonobese patients. World J Surg 2007; 31(3):556-60.
  • 31. Rivera-Gonzalez G, Shook B, Horsley V. Adipocytes in skin health and disease. Cold Spring H Harb Perspect Med 2014;4(3).
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik
Bölüm DERLEME
Yazarlar

Neriman Zengin 0000-0002-1045-7288

Yayımlanma Tarihi 31 Aralık 2014
Yayımlandığı Sayı Yıl 2012 Cilt: 16 Sayı: 2

Kaynak Göster

Bu derginin içeriği Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanmıştır.

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