Research Article Details
| Article ID: | A46194 |
| PMID: | 20446347 |
| Source: | Curr Opin Anaesthesiol |
| Title: | Metabolic syndrome: anesthesia for morbid obesity. |
| Abstract: | PURPOSE OF REVIEW: There is an emerging epidemic of obesity worldwide resulting in a greater number of obese patients presenting for surgery. The combined problems of metabolic disease and mechanical impairment from excess tissues present a variety of problems for the anesthesiologist. RECENT FINDINGS: Obesity is associated with nonalcoholic fatty liver disease, dyslipidemia, hyperglycemia and type 2 diabetes. Metabolic syndrome, a constellation of findings associated with visceral obesity, appears to confer additional long-term risk. To date no intervention has proven effective in reducing perioperative risk, although statin therapy is promising. Obese patients are more difficult to intubate in the 'sniffing' position, but placed in the 'ramped' position there is no evidence that this risk is greater than in the general population. Obstructive sleep apnea is associated with adverse postoperative outcomes. Much research has focused on preventing postoperative atelectasis. Preoxygenation with continuous positive airway pressure (CPAP), recruitment maneuvers, intraoperative positive end-expiratory pressure of at least 8 cmH2O and postextubation CPAP appear to improve postoperative pulmonary function. SUMMARY: Current studies have focused on the immediate impact of obesity on anesthesia and postoperative care. Future research will focus primarily on perioperative metabolic optimization. |
| DOI: | 10.1097/aco.0b013e328338caa0 |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs |
|---|
| Target ID | Target Name | GENE | Action | Class | UniProtKB ID | Entry Name |
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| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I13 | 3146 | Lipid metabolism disorder | An inherited metabolic disorder that involves the creation and degradation of lipids. http://en.wikipedia.org/wiki/Lipid_metabolism | disease of metabolism/ inherited metabolic disorder | Details |
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |