Critical Care and Shock

The obesity supine sudden death syndrome in the perioperative patient

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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.

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