The obesity supine death syndrome (OSDS) is a disease characterized by sudden cardiac arrest in the morbidly obese patient. We present the case of a 50-year-old man who in the immediate postoperative period developed hypoxemia, bradycardia and irreversible cardiac arrest. After a careful review of the perioperative events and a literature review, we attributed his demise to the OSDS. This syndrome is characterized by sudden desaturation following supine position in patients with a body mass index (BMI) in excess of 50 kg/m2. While the pathophysiology of OSDS is not fully understood, perioperative clinicians require an awareness of this condition to avoid this potential fatal outcome.
The obesity supine sudden death syndrome in the perioperative patient