Table 5. Respiratory management of the obese surgical patient—a summary.

Pre-operative assessment

Screening for symptoms of sleep-disordered breathing with specialist respiratory referral if suspected (STOP-Bang questionnaire)

Assessment for co-existent respiratory and cardiac disease

Upper airway assessment e.g., Mallampati score

Mobility assessment

Baseline oxygen saturations on room air and spirometry

Pre-operative planning

Peri-operative continuous positive airways pressure and    non-invasive ventilation

Operative ventilation strategy

Peri-operative patient positioning

Intra- and post-operative analgesia e.g., opiate load and regional anesthesia

Postoperative care location

Intra-operative management

Application of positive end-expiratory pressure

Application of recruitment maneuvers

Patient positioning

Post-operative management

Non-invasive ventilation or continuous positive airways pressure

Respiratory physiotherapy

Careful fluid balance management

Patient positioning

Early mobilization