Perioperative management of the morbidly obese adolescent with heart failure undergoing bariatric surgery

Bryan G. Maxwell, Jerry Ingrande, David N. Rosenthal, Chandra Ramamoorthy

Research output: Contribution to journalReview articlepeer-review

Abstract

The incidence and prevalence of adolescent obesity and adolescent heart failure are increasing, and anesthesiologists increasingly will encounter patients with both conditions. A greater understanding of the physiologic challenges of adolescent heart failure as they relate to the perioperative stressors of anesthesia and bariatric surgery is necessary to successfully manage the perioperative risks faced by this growing subpopulation. Here, we present a representative case of a morbidly obese adolescent with heart failure who underwent a laparoscopic bariatric operation and review the limited available literature on perioperative management in this age group. Specifically, we review evidence and offer recommendations related to preoperative evaluation, venous thromboembolism prophylaxis, positioning, induction, airway management, monitoring, anesthetic maintenance, ventilator management, and adverse effects of the pneumoperitoneum, rhabdomyolysis, and postoperative care.

Original languageEnglish (US)
Pages (from-to)476-482
Number of pages7
JournalPaediatric anaesthesia
Volume22
Issue number5
DOIs
StatePublished - May 1 2012

Keywords

  • adolescent obesity
  • anesthetic implications
  • anesthetic management
  • bariatric surgery
  • cardiomyopathy
  • severe systolic heart failure
  • sleeve gastrectomy
  • teenager obesity
  • weight-loss surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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