ReviewIntensive care medicine2020
How to ventilate obese patients in the ICU.
Review in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 79 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Response of Respiratory and Hemodynamic Parameters to Positive End-Expiratory Pressure Titration for Mechanically Ventilated Obese Patients: A Randomized Clinical Trial
Effects of Body Position on Ventilation and Perfusion Distribution in Obese and Non-Obese Healthy Volunteers Assessed by Electrical Impedance Tomography
Who cites it
79 citing papers in PubMed, 6 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Effect of positive airway pressure on obese patients undergoing surgery: a systematic review and meta-analysis.BMC anesthesiology · 2024Pooled it
- The efficacy of high-flow nasal cannula (HFNC) versus non-invasive ventilation (NIV) in patients at high risk of extubation failure: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Efficacy of High-Flow Nasal Cannula versus Conventional Oxygen Therapy in Obese Patients during the Perioperative Period: A Systematic Review and Meta-Analysis.Canadian respiratory journal · 2022Pooled it
- The association between body mass index and risk of preoperative oxygenation impairment in patients with the acute aortic syndrome.Frontiers in endocrinology · 2022Pooled it
- Awake prone positioning for patients with COVID-19 pneumonia in intensive care unit: A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Effect of different levels of PEEP on mortality in ICU patients without acute respiratory distress syndrome: systematic review and meta-analysis with trial sequential analysis.Journal of critical care · 2021Pooled it
- The Application Effect of Modified Pressure-Reducing Fixation Protective Nasal Strip in the Nursing Care of Patients Receiving High-Flow Nasal Cannula Therapy.Saudi medical journal · 2026Trial
- Comparing the effect of three levels of end-expiratory pressure during facemask ventilation on gastric insufflation in patients with obesity: a randomized controlled trial.Journal of anesthesia · 2025Trial
- Noninvasive ventilation in postoperative critically ill patients with morbid obesity: secondary analysis of the EXTUBOBESE multicentre randomised clinical trial.British journal of anaesthesia · 2025Trial
- Effect of Flow Rates of High-Flow Nasal Cannula on Extubation Outcomes: A Randomized Controlled Trial.Chest · 2025Trial
- Effect of low-volume ropivacaine in ultrasound-guided superior trunk block on diaphragmatic movement in patients undergoing shoulder arthroscopy: a randomized controlled trial.Journal of orthopaedic surgery and research · 2024Trial
- Advanced respiratory mechanics assessment in mechanically ventilated obese and non-obese patients with or without acute respiratory distress syndrome.Critical care (London, England) · 2023Trial
- Invasive ventilation and association with outcomes in heart failure-related cardiogenic shock.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Key principles for rehabilitation of critically ill patients with obesity.Intensive care medicine · 2026Review
- Article
- Acute respiratory distress syndrome in patients with obesity.Intensive care medicine · 2026Article
- ECMO for patients with obesity: evidence and practice.Intensive care medicine · 2026Review
- Obesity: biomechanical implications for mechanical ventilation.Critical care (London, England) · 2026Review
- Airway management in critically ill patients with obesity.Intensive care medicine · 2026Review
- Mechanical ventilation for ICU patient with obesity: current best practices and future directions.Intensive care medicine · 2026Review
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 9 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Obesity is an important risk factor for major complications, morbidity and mortality related to intubation procedures and ventilation in the intensive care unit (ICU). The fall in functional residual capacity promotes airway closure and atelectasis formation. This narrative review presents the impact of obesity on the respiratory system and the key points to optimize airway management, noninvasive and invasive mechanical ventilation in ICU patients with obesity. Non-invasive strategies should first optimize body position with reverse Trendelenburg position or sitting position. Noninvasive ventilation (NIV) is considered as the first-line therapy in patients with obesity having a postoperative acute respiratory failure. Positive pressure pre-oxygenation before the intubation procedure is the method of reference. The use of videolaryngoscopy has to be considered by adequately trained intensivists, especially in patients with several risk factors. Regarding mechanical ventilation in patients with and without acute respiratory distress syndrome (ARDS), low tidal volume (6 ml/kg of predicted body weight) and moderate to high positive end-expiratory pressure (PEEP), with careful recruitment maneuver in selected patients, are advised. Prone positioning is a therapeutic choice in severe ARDS patients with obesity. Prophylactic NIV should be considered after extubation to prevent re-intubation. If obesity increases mortality and risk of ICU admission in the overall population, the impact of obesity on ICU mortality is less clear and several confounding factors have to be taken into account regarding the "obesity ICU paradox".
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.