Page 202 - Critical Care Notes

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GI

Management
■ IAP monitoring (Refer to World Society of the Abdominal Compartment
Syndrome at http://www.wsacs.org)
■ Fluid resuscitation
■ Paracentesis
■ Diuretics: furosemide (Lasix), spironolactone (Aldactone), amiloride
(Midamor)
■ Laparoscopic decompression
■ Surgery possibly indicated to correct the underlying problem
Complications
■ Renal failure
■ Respiratory failure
■ Bowel ischemia
■ Shock
■ Multisystem organ failure and death
Morbid Obesity and Bariatric Surgery
Morbid obesity is defined as a body mass index (BMI) >30–40 kg/m 2 , a body
weight twice the person’s ideal body weight, or a body weight more than 100 lb
greater than the ideal body weight.
Persons who are morbidly obese are at a higher risk for:
■ Diabetes mellitus
■ Cardiovascular disease, including stroke and hypertension
■ Pickwickian syndrome and hypertrophic cardiomyopathy
■ Hyperlipidemia
■ Gallbladder disease
■ Osteoarthritis
■ Obstructive sleep apnea
■ Obesity hypoventilation syndrome
■ Polycystic ovarian syndrome
■ Hypothyroidism, Cushing’s disease, or adrenal hyperplasia
■ Certain cancers (uterine, breast, colorectal, kidney, and gallbladder)
Psychosocial problems may also coexist:
■ Low self-esteem
■ Impaired body image
■ Depression
■ Social anxiety/isolation
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