Key result
Preoperative respiratory muscle training, off-pump coronary artery bypass grafting, and early extubation showed potential benefits for morbidly obese patients undergoing cardiac surgery.
Why the study?
Class III obese patients face high surgical risks, yet there are no defined best practice national guidelines for their perioperative management during cardiac surgery.
Do perioperative interventions improve outcomes in morbidly obese patients undergoing cardiac surgery?
Do perioperative interventions improve outcomes in morbidly obese patients undergoing cardiac surgery?
Preoperative respiratory muscle training, off-pump CABG, and early extubation show promise in improving outcomes for morbidly obese patients undergoing cardiac surgery.
Should not yet change practice in morbidly obese cardiac surgery patients; hypothesis-generating for targeted perioperative strategies.
BACKGROUND: Obesity rates globally continue to rise and in turn the body mass index (BMI) of patients undergoing cardiac surgery is set to mirror this. Patients who are Class III obese (BMI ≥ 40) pose significant challenges to the surgical teams responsible for their care and are also at high risk of complications from surgery and even death. To improve outcomes in this population, interventions carried out in the preoperative, operative, and postoperative periods have shown promise. Despite this, there are no defined best practice national guidelines for perioperative management of obese patients undergoing cardiac surgery. AIM: This review is aimed at clinicians and researchers in the field of cardiac surgery and aims to form a basis for the future development of clinical guidelines for the management of obese cardiac surgery patients. METHODS: The PubMed database was utilized to identify relevant literature and strategies employed at various stages of the surgical journey were analyzed. CONCLUSIONS: Data presented identified the benefits of preoperative respiratory muscle training, off-pump coronary artery bypass grafting where possible, and early extubation. Further randomized controlled trials are required to identify optimal operative and perioperative management strategies before the introduction of such guidance into clinical practice.
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Djouani et al. (2022) conducted a review in Morbid obesity (Class III obese, BMI ≥ 40) undergoing cardiac surgery. Perioperative management strategies (preoperative respiratory muscle training, off-pump CABG, early extubation) was evaluated. Preoperative respiratory muscle training, off-pump coronary artery bypass grafting, and early extubation showed potential benefits for morbidly obese patients undergoing cardiac surgery.
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