Tracheostomy in the Morbidly Obese: Difficulties and Challenges

Area of Science:

• Surgical procedures
• Critical care medicine
• Obesity medicine

Background:

• Morbid obesity (body mass index [BMI] ≥30 kg/m²), presents unique surgical challenges.
• Open tracheostomy is an increasingly utilized procedure in this patient population.

Purpose of the Study:

• To evaluate the difficulties and challenges of open tracheostomy in morbidly obese patients.
• To assess perioperative complications associated with the procedure.

Main Methods:

• Retrospective chart review of 40 morbidly obese patients undergoing open tracheostomy.
• Evaluation of indications, intubation duration, operative time, and perioperative complications.

Main Results:

• Average BMI was 46 kg/m².
• Average intubation duration before tracheostomy was 11 days.
• Perioperative complications occurred in 22.5% of patients (5% intraoperative, 17.5% postoperative).
• Average operative time was 60 minutes, with an average total operating room time of 100 minutes.

Conclusions:

• Open tracheostomy in morbidly obese patients can be performed predictably.
• The procedure is associated with longer durations and a higher perioperative complication rate compared to traditional tracheostomy.