Objective:

To discuss how interprofessional rehabilitation can be adapted to the altered pathophysiology of critically ill patients with obesity.

Approach:

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Key Findings:

• Obesity is increasingly common in ICUs and presents specific challenges in management.
• Sarcopenic obesity is associated with poor outcomes and increased risk of ICU acquired weakness (ICUAW).
• The relationship between obesity and critical illness outcomes is complex and influenced by various factors, including body composition and age.
• Obesity can present with preserved or reduced muscle mass, influencing patient outcomes.
• Three distinct obesity phenotypes exist, each requiring tailored rehabilitation approaches.

Interpretation:

The relationship between obesity and critical illness outcomes is complex and influenced by various factors, including body composition and age.

Limitations:

• The level of evidence is low, with recommendations primarily based on expert opinion.
• The independent influence of obesity on ICUAW development is not well understood.

Conclusion:

Future research is needed to clarify how obesity phenotypes influence post-ICU outcomes and to develop targeted rehabilitation strategies.