RT Journal Article SR Electronic T1 Current practice in reducing perioperative and critical care pulmonary complications in obese patients: A review of London bariatric services JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA2145 DO 10.1183/13993003.congress-2016.PA2145 VO 48 IS suppl 60 A1 Thomas Carter A1 Tim Knowles YR 2016 UL http://erj.ersjournals.com/content/48/suppl_60/PA2145.abstract AB Introduction: Obese patients are high risk of pulmonary complications in both the peri-operative and critical care settings, including: hypoxia, pulmonary aspiration, venous thromboembolism and difficult airway management. The Association of Anaesthetists for Great Britain and Ireland (AAGBI)(1) have released guidelines to ameliorate these risks and recommend:· Pre oxygenation with positive end expiratory pressure· Ramped position· Bariatric enabled post-operative care areas· Prophylactic thromboprophylaxisAim: To compare current practice in bariatric services across London.Methods: Seven major London bariatric services were surveyed regarding local anaesthetic Bariatric guidelines and their recommended practice in relation to the above recommended list alongside use of rapid sequence intubation (RSI) and intubation modality.Results: 5 bariatric services responded. 3/5 reported specific trust guidelines for the anaesthetic care of bariatric patients. All trusts (5/5) routinely used the ramped position prior to intubation, pre-oxygenation with PEEP, Video –laryngoscope as intubation modality and heparin based thromboprophylaxis. RSI was not routinely used.Post operatively patients from all trusts went to a dedicated bariatric enabled post-anaesthetic care area but not HDU unless otherwise indicated.Conclusion: Only 60% of the Services responding to our survey had formalized guidelines for the management of bariatric patients. All Services, however, provided details consistent with current AAGBI guidelines. Further work to assess compliance with guidelines and its impact on patient outcomes.1. AAGBI. Anaesthesia 2015;70:859–876.