Do all morbidly obese patients have a difficult airway?

Abstract

There has long been held an acceptance that morbidly obese patients present problems with airway management. This chapter will highlight arguments that both agree with and challenge this assumption. Recent studies question the correlation between elevated BMI and difficult direct laryngoscopy, probably because excess adipose tissue has a variable distribution among MO patients. The reader will be able to identify a subset of MO patients where difficult airway management is indeed expected. In such patients, maximizing oxygenation is of primary importance. This chapter will therefore also highlight best practice in terms of preoxygenation and recruitment maneuvers which minimize atelectasis. Suggested alternatives to direct laryngoscopy that achieve rapid intubation will be recommended.