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Table 1 Pathophysiological specificities of the obese patient

From: Mechanical ventilation in obese ICU patients: from intubation to extubation

1. Lung volume – Atelectasis in the dependent pulmonary area
functional residual capacity (FRC)
intra‐abdominal pressure
– Diaphragm passively pushed cranially
thoracic and pulmonary compliance
2. Airway resistances (but normal after normalization to the functional lung volume)
work of breathing
risk factors for difficult mask ventilation (age > 55 years old, snoring, beard, lack of teeth, obstructive apnea syndrome, associated congenital diseases) and difficult intubation (MACOCHA score: Mallampati III or IV, obstructive apnea syndrome, limited mouth opening, reduced cervical mobility, coma, hypoxemia, operator not trained, associated congenital diseases)
3. Ventilatory control ventilatory response to hypercapnia and hypoxia in case of obesity hypoventilation syndrome
breath rate
4. Pulmonary circulation – Post‐capillary pulmonary hypertension if associated cardiac dysfunction, pre‐capillary if use of toxins (anorectics)
5. Blood gas exchange oxygen consumption
carbon dioxide production
6. Comorbidities – Obstructive apnea syndrome
– Obesity hypoventilation syndrome