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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: 24 October 2020

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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