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Obesity and systemic physiology 

Obesity and systemic physiology
Obesity and systemic physiology

Mark Bellamy

and Michel Struys

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date: 19 October 2017

• Obesity and related co-morbidities result in physiological abnormalities that can have a major impact in the perioperative period. • Not all features of physiological derangement are seen in all patients. • Gynaecoid fat distribution is less severe, whereas the android fat distribution carries greater pathophysiological significance. • Both obstructive sleep apnoea and the obesity hypoventilation syndrome can result in a chronically raised carbon dioxide tension. • As body mass index increases, there is a progressive decline in functional residual capacity. • There is an increased shunt in obese patients undergoing anaesthesia. • The extent and severity of cardiovascular changes seen in obesity is highly variable, depending on factors including body mass index and duration of obesity. • Increase in body mass index results in increased myocardial fat content and reduced contractility. • Many obese patients develop right heart complications. • The prevalence of fatty liver is up to 90%. • Hiatus hernia is common in morbid obesity.

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