Should Obese Surgical Patients be Recovered in an ICU or PACU? Should all Postoperative MO Patients be Monitored During Their Entire Hospitalization?

The spectrum of requirements for postoperative levels of care and monitoring in obese surgical patients is determined by a multitude of patient and surgical factors. Monitoring is merely a tool to provide early warning of deterioration. The availability of higher level monitoring facilities, i.e. intensive care beds, is a major determinant of admission. Matching the level of postoperative care and observation to the likely needs of the patients is critical, and in our current resource-limited healthcare systems we are duty-bound to be focussed on who should receive this expensive resource. This chapter discusses the problems that occur in the peri-operative period, how ICU care can impact upon these problems, the commonly used monitoring modalities and recommendations on their use, and describes how hospital systems evolve with increasing experience to optimally match supply of postoperative care resources to demand.