Obesity supine death syndrome revisited.

Given the current worldwide epidemic of obesity, it is likely that an increasing number of obese patients will be admitted to hospital in the future [1]. Caring for morbidly obese patients is a critical task that is time-consuming, and requires a trained and motivated staff. One particular hurdle to overcome in the management of these patients is positioning. Unfortunately, this is rarely considered a high priority issue in the emergency setting, despite the potential for dramatic cardiopulmonary complications resulting from the supine positioning of massively obese patients. In extreme cases, it may even result in death. This catastrophic phenomenon has been called the ‘‘obesity supine death syndrome’’. However, only two other cases of this condition have been previously reported [2], and therefore it remains relatively unfamiliar to most physicians. We recently managed a 44-yr-old male with a body mass index of 80 kg?m who immediately developed severe hypoxaemia, seizures and cardiovascular collapse when placed in the supine position. This case gives us an insight into understanding the underlying mechanisms leading to position-induced cardiorespiratory decompensation in morbidly obese patients.