The pleural gradient does not reflect the superimposed pressure in patients with class III obesity
In patients with class III obesity, the superimposed pressure does not approximate the pleural pressure gradient, which is higher than in patients with lower BMI. The quantity and distribution of subcutaneous and intrathoracic adiposity also contribute to increased pleural pressure gradients in individuals with BMI ≥ 40. This study introduces a novel physiological concept that provides a solid rationale for tailoring mechanical ventilation in patients with high BMI, where specific guidelines recommendations are lacking.
Authors
- Edward A. Bittner (ORCID: https://orcid.org/0000-0002-0159-2373)
- Lea Mantz (ORCID: https://orcid.org/0000-0003-0998-8812)
- Florian J. Fintelmann (ORCID: https://orcid.org/0000-0002-0119-3903)
- Alice Nova (ORCID: https://orcid.org/0000-0002-3769-6406)
- Luigi Giuseppe Grassi (ORCID: https://orcid.org/0000-0002-1050-4494)
- Stefano Spina (ORCID: https://orcid.org/0000-0003-3210-1714)
- Lorenzo Berra (ORCID: https://orcid.org/0000-0003-2702-2093)
- Sarah E. Gerard (ORCID: https://orcid.org/0000-0001-8101-3150)
- Roberta Ribeiro De Santis Santiago (ORCID: https://orcid.org/0000-0002-5818-0361)
- Maurizio Cereda (ORCID: https://orcid.org/0000-0002-2435-7413)
- Yi Xin (ORCID: https://orcid.org/0000-0003-0539-809X)
- David C Moscho
Institutions
- University of Iowa (US)
- Harvard University (US)
- Johannes Gutenberg University Mainz (DE)
- Ospedale Maggiore (IT)
- Massachusetts General Hospital (US)
- Düsseldorf University Hospital (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Heinrich Heine University Düsseldorf (DE)
Publication Details
- Journal
- Critical Care
- Published
- 2024-09-16
- DOI
- https://doi.org/10.1186/s13054-024-05097-6
- Citations
- 9
- Primary Topic
- Respiratory Support and Mechanisms
- Type
- article
- Field-Weighted Citation Impact
- 3.77
Funders
- Massachusetts General Hospital