ArticleThe Journal of trauma2010
Traditional resuscitative practices fail to resolve metabolic acidosis in morbidly obese patients after severe blunt trauma.
Article in The Journal of trauma, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Who cites it
13 citing papers in PubMed, 37 citations in OpenAlex.
- Obesity influences the biological response to injury: a multi-omics analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Dietary pH Enhancement Improves Metabolic Outcomes in Diet-Induced Obese Male and Female Mice: Effects of Beef vs. Casein Proteins.Nutrients · 2022Article
- Obesity associated with increased postoperative pulmonary complications and mortality after trauma laparotomy.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- The association of post-lung transplant acute kidney injury with mortality is independent of primary graft dysfunction: A cohort study.Clinical transplantation · 2019Article
- The Role of BMI in Hip Fracture Surgery.Geriatric orthopaedic surgery & rehabilitation · 2018Article
- Defining multiple organ failure after major trauma: A comparison of the Denver, Sequential Organ Failure Assessment, and Marshall scoring systems.The journal of trauma and acute care surgery · 2017Observational
- The ebb and flow of fluid (as in resuscitation).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2015Review
- Physiological and management implications of obesity in critical illness.Annals of the American Thoracic Society · 2014Review
- Computed tomography-defined abdominal adiposity is associated with acute kidney injury in critically ill trauma patients*.Critical care medicine · 2014Article
- Year in review 2012: Critical Care--Out-of-hospital cardiac arrest and trauma.Critical care (London, England) · 2013Article
- Obese trauma patients are at increased risk of early hypovolemic shock: a retrospective cohort analysis of 1,084 severely injured patients.Critical care (London, England) · 2012Article
- Obese patients show a depressed cytokine profile following severe blunt injury.Shock (Augusta, Ga.) · 2012Article
- Differences in resuscitation in morbidly obese burn patients may contribute to high mortality.Journal of burn care & research : official publication of the American Burn AssociationObservational
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundObesity is a risk factor for postinjury complications; in particular, obese patients develop multiple organ failure (MOF) at a greater rate than do normal weight counterparts. Evaluation of differences in resuscitative practices altered by body mass index (BMI) might provide an explanation for the increased risk of MOF seen in these high-risk patients.
methodsWe used prospectively collected multicenter data to retrospectively compare patients grouped by BMI with regard to resuscitation volumes and traditional end points during the first 48 hours after injury. Marshall MOF score was used as the primary outcome measure.
resultsOne thousand sixty-six patients were analyzed, with 877 meeting inclusion and exclusion criteria. All patients received similar volumes of resuscitation per kilogram lean and ideal body weight. Morbidly obese patients attained greater central venous pressures but otherwise differed little in attainment of standard cardiovascular end points. Despite this, morbidly obese patients resolved base deficit more slowly and remained in metabolic acidosis for 48 hours postinjury. Morbidly obese patients with persistent metabolic acidosis developed MOF at a significantly greater rate than did normal weight patients with or without persistent metabolic acidosis.
conclusionsMorbidly obese trauma patients show prolonged metabolic acidosis despite receiving similar volumes and attaining similar end points of resuscitation when compared with patients in other BMI groups. Inadequate resuscitation based on inaccurate end points and metabolic disturbances associated with increased BMI are likely responsible; identification of the etiology, sources, and consequences of this acidosis may provide further insight into the susceptibility of the morbidly obese patient to develop postinjury organ failure.
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