重症监护病房的胖患者:风险与结局

Obesity Patients in Intensive Care Unit: Risks and Outcomes

肥胖以脂肪组织大量蓄积为特征,是与多种疾病相关的慢性疾病状态。在全球范围内,肥胖的患病率逐年增高,重症肥胖患者不仅合并心血管、肺以及肾脏疾病的风险增高,而且还给有创机械通气、血流动态监测、药代动力学以及营养支持等方面带来巨大挑战。然而与大部分人的主观推断相反,有研究认为肥胖并未增加重症监护病房患者的病死率,相反重症肥胖患者改善了重症监护病房患者的预后。该机制目前尚不明确,但已引起了越来越多的关注和争论。

Obesity is a chronic disease characterized by fat tissue accmnulation and associated with many diseases. The prevalence of obesity has been increasing globally. On one hand, the risks of severe obesity combined with angiocardiopathy, pulmonary disease and kidney disease are increased;on the other hand, severe obesity has brought great challenges to inva- sive mechanical ventilation, blood flow monitoring, pharmacokinetics and nutritional support. Contrary to subjective assump-tions of most people, obesity did not increase the mortaliU in intensive care unit （ICU） , and severe obesity improves ICU patients＇ outcomes. The mechanism is still unclear, but it has attracted more and more researchers＇ attention and generated a lot of debate.