Critical Illness in the Obese Patient

We review studies examining the impact of obesity on survival, morbidity, and respiratory failure in critical illness. Given the increasing rates of overweight and obesity, there is a surprising lack of well-conducted clinical trials addressing its interaction with critical illness. Unexpectedly, it seems that obesity may not negatively impact, or may even be protective with regards to mortality, though there are a few studies that support conventional wisdom, demonstrating worsened outcomes amongst the obese. Being obese does seem to predispose to respiratory failure, given altered lung and chest wall mechanics, and increased metabolic demands, though it is uncertain how it might impact survival in patients requiring ventilatory support.