Intensive Care Medicine

, Volume 34, Issue 11, pp 1991–1998

Impact of obesity in mechanically ventilated patients: a prospective study

  • Jean-Pierre Frat
  • Valérie Gissot
  • Stéphanie Ragot
  • Arnaud Desachy
  • Isabelle Runge
  • Christine Lebert
  • René Robert
  • for the Association des Réanimateurs du Centre-Ouest (ARCO) study group
Original

Abstract

Objective

To analyze the influence of severe obesity on mortality and morbidity in mechanically ventilated intensive care unit (ICU) patients.

Design

Prospective, multi-center exposed/unexposed matched epidemiologic study.

Setting

Hospital setting.

Patients

Severely obese patients (body mass index (BMI) ≥ 35 kg/m2), mechanically ventilated for at least 2 days were matched with unexposed nonobese patients (BMI < 30 kg/m2) for center, gender, age (±5 years), and the simplified acute physiology (SAPS) II score (±5 points). We recorded tracheal intubation, catheter placement, nosocomial infections, development of pressure ulcers, ICU and hospital outcome.

Results

Eighty-two severely obese patients (mean BMI, 42 ± 6 kg/m2) were compared to 124 nonobese patients (mean BMI, 24 ± 4 kg/m2). The ICU course was similar in both the groups, except for the difficulties during tracheal intubation (15 vs. 6%) and post-extubation stridor (15% vs. 3%), which were significantly more frequent in obese patients (< 0.05). The ICU mortality rate did not differ between obese and nonobese patients (24 and 25%, respectively); nor did the risk-adjusted hospital mortality rate (0.76, 95% confidence interval 0.41–1.16 in obese patients versus 0.82, 95% confidence interval 0.54–1.13 in nonobese patients). Conditional logistic regression confirmed that mortality was not associated with obesity.

Conclusion

The only difference in morbidity of obese patients who were mechanically ventilated was increased difficulty with tracheal intubation and a higher frequency of post-extubation stridor. Obesity was not associated either with increased ICU mortality or with hospital mortality.

Keywords

Obesity Mortality Morbidity Mechanical ventilation Intensive care unit Post-extubation stridor 

Supplementary material

134_2008_1245_MOESM1_ESM.doc (31 kb)
Demographic characteristics of nonobese, included and unmatchable obese study patients (DOC 31 kb)

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Jean-Pierre Frat
    • 1
  • Valérie Gissot
    • 2
  • Stéphanie Ragot
    • 3
  • Arnaud Desachy
    • 4
  • Isabelle Runge
    • 5
  • Christine Lebert
    • 6
  • René Robert
    • 1
  • for the Association des Réanimateurs du Centre-Ouest (ARCO) study group
  1. 1.Medical ICUCHU PoitiersPoitiers cedexFrance
  2. 2.Medical ICUCHU BretonneauTours cedexFrance
  3. 3.Clinical Research CenterCHU PoitiersPoitiers cedexFrance
  4. 4.Medical-Surgical ICUCentre Hospitaliers d’AngoulêmeSaint MichelFrance
  5. 5.Medical-Surgical ICUHopital de la SourceOrléans cedexFrance
  6. 6.Medical-Surgical ICUHôpital de la Roche Sur YonLa Roche Sur YonFrance

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