Surgical Indications for the Obese Flashcards
What percentage of adults in the US are considered obese?
65%
What percentage of adolescents and children are obese in the US?
15%
What is a determining factor in development of co-morbidities related to weight?
BMI
At what BMI is a patient considered low risk for developing co-morbidities?
BMI of 25-30
At what BMI is a patient considered high risk for developing co-morbidities?
BMI greater than 40
What percentage of anesthetic incidents involve obesity as a contributing factor?
50%
What were majority of the closed claims extubation or recovery claims related to?
Difficult intubation on induction, obesity or OSA
What is the most practical way to figure out IBW?
Broca’s index:
Male: IBW = ht (cm) - 100
Female IBW = ht (cm) -105
What is the formula to calculate a patient’s BMI?
Quetelet’s Index
weight in kg) / (height in meters squared
What does ideal body weight tell us?
Measurement of height compared to body mass
What does the NIH consider as a Grade I obese patient?
BMI 26-29.9
What does the NIH consider as a Grade II obese patient?
BMI 30-39.9
What does the NIH consider as a Grade III obese patient?
BMI greater than 40
What is considered a normal BMI?
BMI 24-26
What is considered mild obesity?
BMI 27-30
What is considered moderate obesity?
BMI 31-35
What is considered severe/morbid obesity?
BMI greater than 35
What is considered super morbid obesity?
BMI greater than 55
What are the two type of obesity?
Android “Apple”
Gynecoid “Pear”
How does a patient with android obesity present?
Significant weight above the waist, especially in the face and neck
The adipose is centrally deposited
How does a patient with gynecoid obesity present?
Weight is carried below the waist
What is a more efficient predictor of mortality than BMI or waist circumference alone?
Fat distribution
What is considered low, moderate and high risk in females based on their waist to hip ratios?
Low: 0.8
Moderate: 0.81-0.85
High: 0.85 and up
What is considered low, moderate and high risk in males based on their waist to hip ratios?
Low: 0.95
Moderate: 0.96-1
High: 1 and up
What medical risks are associated with android fat distribution?
Increased myocardial fat content
Ischemic hear disease
NIDDM
Stroke
What medical risks are associated with gynecoid fat distribution?
Varicose veins
Degenerative joint disease
Fat metabolically static
What gender is android fat distribution typically seen in?
Males
What can occur when free fatty acids are delivered to the liver?
Stimulation of hepatic synthesis of VLDL and increased circulation of LDL
Glyconeogenesis and inhibition of insulin uptake –> NIDDM
Define concentric hypertrophy.
Increased wall thickness and diminished volume