Open Lung Strategy in Critically Ill Morbid Obese Patients

Obese patients under mechanical ventilation are more likely to develop atelectasis as a consequence of the increased abdominal weight. Atelectasis is the primary responsible for respiratory insufficiency and impossibility to wean obese patients from respiratory support. In a previous study we demonstrated the efficacy of the application of titrated PEEP levels following a recruitment maneuver in obese patients, i.e. improvement in respiratory mechanics and gas exchanges without negative hemodynamic effects. The application of lung and heat imaging will allow us to quantitatively describe: * Increase in aerated lung tissue (reduction of atelectasis) * Reduction of over-inflation of the ventilated regions * Recoupling of ventilation and perfusion * Improvement in right heart function by reduction of right heart afterload