Management of Infectious Complications in the Critically Ill Obese Patient

Managing infectious complications in obese critically ill patients presents unique challenges and is associated with significant cost to the health care industry. Generally, obese patients tend to have a higher incidence of blood-stream, catheter-related, and surgical-site infections. Physiologically, obesity is a chronic inflammatory state, which may result in an exaggerated immune response to sepsis. Adipocytes release cytokines and adipokines that have been implicated in the proinflammatory phenotype of obesity. Not only is aggressive prevention of infection by a multidisciplinary team valuable, but narrowing antibiotics to target the organisms present is fundamental in obese patients.