Obesity has become a global epidemic with prevalence rising both in developed and developing countries. The percentage of patients with obesity in the intensive care unit (ICU) can be expected to increase concomitantly or even more since obesity increases the risk for a more severe disease course with more need for ICU admission and mechanical ventilation .
Obesity, especially abdominal obesity (android fat distribution) and severe obesity, results in altered respiratory anatomy and physiology and, therefore, complicated airway management and adapted ventilator settings during mechanical ventilation. Obesity appears to be associated with an increased risk of acute respiratory distress syndrome (ARDS) and infection, mainly pneumonia probably related to an imbalanced production of adipokines. In ventilated patients, obesity increases ICU length of stay and the duration of mechanical ventilation .
Obesity is relatively common among individuals with COPD, corresponding to 20%-35% of patients with COPD. Increasing evidence suggests that obesity is a risk factor for impaired quality of life, exercise intolerance, and suboptimal disease control in COPD .
