Respiratory failure & ventilation
Advanced respiratory mechanics assessment in mechanically ventilated obese and non-obese patients with or without acute respiratory distress syndrome
Authors' conclusion
Most respiratory mechanics features are similar in obese non-ARDS and non-obese ARDS patients, but end-expiratory esophageal pressure is higher in obese patients. A complete airway closure can be found in around 25% of critically ill patients ventilated with a PEEP of 5 cmH2O.
Study context
- Population
- Intubated ICU patients admitted for any cause, assessed within 24 h after intubationanalysed
- Participants
- 149 patients
- Exposure
- Obese vs non-obese; ARDS vs non-ARDS
- Obesen = 52
- ARDSn = 90
- Outcome
- Complete airway closure
- Follow-up
- Within 24 h after intubation
Methodological detailstwo ICUs, standardized conditions (tidal volume 6 mL kg-1 predicted body weight (PBW), positive end-expiratory pressure (PEEP) 5 cmH2O)
- Two ICUs
- Standardized conditions (tidal volume 6 mL kg-1 PBW, PEEP 5 cmH2O)
Main finding
As reported in the abstract
Obese vs Non-obese: P < 0.001 · ARDS vs Non-ARDS: P = 0.029
- Complete airway closure, all patients
- 23.5%
Observational data: associations, not effects.
Further findings
| Outcome | Obese | Non-obese | P value |
|---|---|---|---|
| ARDS prevalence by obesityObese vs Non-obese | 65.4% | 57.8% | P = 0.385 |
Respiratory system and lung compliances, end-expiratory lung volume (EELV)/PBW
- Similarly decreased in obese without ARDS and obese or non-obese with ARDS
Chest wall compliance and end-expiratory esophageal pressure
- Chest wall compliance not impacted by obesity or ARDS
- End-expiratory esophageal pressure higher in obese than non-obese
- Chest wall contribution to respiratory system compliance varied widely, not predictable by general characteristics
Original publication
Advanced respiratory mechanics assessment in mechanically ventilated obese and non-obese patients with or without acute respiratory distress syndrome. Crit Care. Published 4 September 2023. doi:10.
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