The Patient with OBESITY: VENTILATION - differences : DR LORENZO BERRA (HARVARD MEDICAL SCHOOL)

DR Lorenzo Berra from Harvard Medical School presents studies on obesity, mortality, and the importance of positive airway pressure in obese patients. He discusses the hemodynamic effects of airway pressure in patients with ARDS and the importance of optimizing positive airway pressure. Finally, he addresses ventilation in obese patients with ARDS, debunking the myth of the "obesity paradox" and emphasizing the importance of an individualized approach.

Summary
Study On Obesity And Its Correlation With Mortality
Lorenzo presents a study on obesity and its correlation with mortality, highlighting the importance of positive airway pressure in obese patients. He discusses the results of several studies showing that CPAP can improve respiratory function and reduce the risk of reintubation in obese critically ill patients after extubation. Lorenzo emphasizes the importance of understanding respiratory physiology in obese patients to optimize mechanical ventilation and improve clinical outcomes.
Hemodynamic Effects of Airway Pressure in ARDS
Lorenzo presents the results of a study on the hemodynamic effects of airway pressure in patients with ARDS. He discusses how increased airway pressure affects arterial pressure, right and left ventricular function, and transmural pressure. Lorenzo emphasizes the importance of optimizing positive pressure to improve lung function while reducing the negative effects on right ventricular function.


00:02:00 intro
00: 05:50 obesity paradox
00:08:05 airway closure
00:20:00 atelectasis, PEEP
00:35:20 hemodynamics
00:42:05 discussion