{"title":"Pulmonary and cardiovascular derangements in the obese patient.","authors":"R W Vaughan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"19-39"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biochemical and biotransformation alterations in obesity.","authors":"R W Vaughan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"55-70"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Care of the morbidly obese person (BMI greater than or equal to 30) during the perioperative period is specific and differs from routine nursing care. Effective communication, preplanning, and psychologic and physiologic assessment, with appropriate intervention (pulmonary and circulatory), result in positive care outcomes. Preoperative care emphasizes both psychologic and physiologic support concurrent with evaluation of vital signs, fluid status, teaching, and administration of preoperative medications (see Table 1). Intra- and postoperative care incorporates the necessity of additional personnel, transport precautions, physical protection, positioning, oxygenation, and early ambulation coupled with accurate arterial blood gas sampling, intraarterial line care, and cardiopulmonary and fluid status monitoring (see Tables 2 and 5). New information regarding hypothermia and shivering documented to occur in the recovery room underlines the need for accurate core temperature monitoring (see Tables 3 and 4; Figs. 1 and 2). An assessment tool (see Fig. 3)--an effective reminder of important aspects of patient care in the recovery room and until hospital discharge--provides a systematic guide to facilitate nursing care, recording, and reporting.
{"title":"Nursing care for the severely obese patient.","authors":"M S Vaughan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Care of the morbidly obese person (BMI greater than or equal to 30) during the perioperative period is specific and differs from routine nursing care. Effective communication, preplanning, and psychologic and physiologic assessment, with appropriate intervention (pulmonary and circulatory), result in positive care outcomes. Preoperative care emphasizes both psychologic and physiologic support concurrent with evaluation of vital signs, fluid status, teaching, and administration of preoperative medications (see Table 1). Intra- and postoperative care incorporates the necessity of additional personnel, transport precautions, physical protection, positioning, oxygenation, and early ambulation coupled with accurate arterial blood gas sampling, intraarterial line care, and cardiopulmonary and fluid status monitoring (see Tables 2 and 5). New information regarding hypothermia and shivering documented to occur in the recovery room underlines the need for accurate core temperature monitoring (see Tables 3 and 4; Figs. 1 and 2). An assessment tool (see Fig. 3)--an effective reminder of important aspects of patient care in the recovery room and until hospital discharge--provides a systematic guide to facilitate nursing care, recording, and reporting.</p>","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"111-34"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anesthetic management should concentrate on various aspects of pre-, intra-, and postoperative care. Particular laboratory studies, such as arterial blood gases, electrocardiogram, selected pulmonary function tests (e.g., ERV), and serum hepatic profile, can be quite useful. Preoperatively, technical difficulties (intravenous and arterial cannulae, operative positioning, and airway assessment), psychologic considerations, and response to preanesthetic medications can be anticipated. Intraoperative concerns encompass the choice of regional versus general anesthesia, anesthetic biotransformation, and variables influencing intraoperative oxygenation (e.g., effects of general anesthesia, operative position, abdominal packing). Postoperative concerns are directed toward minimizing postoperative hypoxemia, peripheral phlebothrombosis, and fluid imbalances. Special caution is needed in operations subsequent to jejunoileal bypass surgery. Specific choices of anesthetic agents and techniques await further clinical and laboratory investigations in this unique subset of the population.
{"title":"Anesthetic management of the morbidly obese patient.","authors":"R W Vaughan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anesthetic management should concentrate on various aspects of pre-, intra-, and postoperative care. Particular laboratory studies, such as arterial blood gases, electrocardiogram, selected pulmonary function tests (e.g., ERV), and serum hepatic profile, can be quite useful. Preoperatively, technical difficulties (intravenous and arterial cannulae, operative positioning, and airway assessment), psychologic considerations, and response to preanesthetic medications can be anticipated. Intraoperative concerns encompass the choice of regional versus general anesthesia, anesthetic biotransformation, and variables influencing intraoperative oxygenation (e.g., effects of general anesthesia, operative position, abdominal packing). Postoperative concerns are directed toward minimizing postoperative hypoxemia, peripheral phlebothrombosis, and fluid imbalances. Special caution is needed in operations subsequent to jejunoileal bypass surgery. Specific choices of anesthetic agents and techniques await further clinical and laboratory investigations in this unique subset of the population.</p>","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"71-94"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Definitions and risks of obesity.","authors":"R W Vaughan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthesia and the obese patient.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"1-139"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The liver in obesity.","authors":"J B Bentley","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"5 ","pages":"41-53"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18100515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthesia risk factors in patients with liver disease.","authors":"N M Greene","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"4 ","pages":"87-109"},"PeriodicalIF":0.0,"publicationDate":"1981-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18061059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthesia and the patient with liver disease.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75737,"journal":{"name":"Contemporary anesthesia practice","volume":"4 ","pages":"1-184"},"PeriodicalIF":0.0,"publicationDate":"1981-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18242158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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