A mechanically ventilated, super‐morbidly obese patient weighting 172 kg with a body mass index of 54 kg.m−2 required transfer from our intensive care unit to the computed tomography (CT) scanner. Although the maximum weight limit of the CT table had been considered (200 kg at our institution), the implications of the patient's abdominal circumference had been overlooked. This was only realised once the patient had been transferred to the scanner and onto the CT table, when it became evident they would not fit within the scanner. This patient, whose trachea was intubated, had therefore been exposed to the risks of a critical care transfer, with ultimately had no clinical benefit.In retrospect, we discovered the diameter of our CT scanner's aperture to be 70 cm. The patient's chest diameter alone was 74 cm. With the prevalence of obesity ever increasing, we would encourage colleagues to consider this additional dimension when caring for the bariatric patient, and not just focus on body mass in isolation. Computed tomography scanners do vary in their gantry aperture, with more modern scanners typically 75–85 cm in diameter . This information should be available from radiology staff, or alternatively a simple tape measure may be enough to prevent a wasted journey to CT.ReferenceFursevich DM, LiMarzi GM, O'Dell MC, Hernandez MA, Sensakovic WS. Bariatric CT imaging: challenges and solutions. Radiographics 2016; 36: 1076–86.
Anaesthesia – Wiley
Published: Jan 1, 2018
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