When Appearances Can be Deceiving: Sarcopenia and Obesity Paradox. Unsolved Issues in Critically Ill Surgical Patients

Abstract

Faced with the complexity of emergency surgery and the aging of the population, it is increasingly common to have to deal with critically ill patients who require intensive care postoperatively. Surgical stress amplifies senescence mechanisms where the organism is called to face the establishment of both early and late pathophysiological mechanisms disrupting homeostasis. In this scenario, sarcopenia represents a prognostic factor with a multifactorial etiology that can lead to fearful com-plications in the early postoperative period. As an octogenarian adaptation, its multifactorial genesis allows to act and counterbalance the action of concomitant modifiable factors through post-operative optimization strategies.