6.有關肥胖病患（BMI>30）的生理變化與手術前評估敘述，下列何者錯誤？
(A)肥胖病患循環血量增加，心搏輸出增加，耗氧量亦增加，心臟易缺血
(B)肥胖病患的每分鐘呼吸次數與通氣量不變
(C)在腸胃道方面，肥胖病患易有胃食道逆流
(D)肥胖病患通常困難插管的機會較高

A) 正確: Physiological changes include increased cardiac output of 20–30 ml/kg of excess body fat. This is accomplished by LV dilation and increased stroke volume, which can lead to LV hypertrophy, diastolic dysfunction, elevated LVEDP and pulmonary edema.⁴ Additionally obese patients frequently have co-morbidities associated with cardiovascular disease such as HTN, dyslipidemia, myotonic dystrophy type 2, and sleep disorders.⁵ Some studies suggest an increased risk of cardiovascular disease in obesity even after accounting for these comorbidities. ^6,7 A meta-analysis of over 300,000 patients with 18,000 coronary artery disease (CAD) events show a five-unit increase in BMI was associated with 29% increased risk of coronary heart disease (CHD)

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B) 錯誤: Obesity is known to decrease chest wall and lung compliance which leads to decreased functional reserve capacity (FRC), vital capacity (VC), and total lung capacity (TLC).⁴ The decrease in FRC is mostly due to a reduction in expiratory reserve volume (ERV). With general anesthesia, patients with obesity may have up to a 50% reduction in FRC ... Excess fat is metabolically active leading to increases in oxygen consumption and carbon dioxide production in patients with obesity. Obesity hypoventilation syndrome (OHS) is chronic hypoventilation secondary to obesity and is often underdiagnosed. OHS occurs in 5–10% of patients with class 3 obesity and increases risk of postoperative complications and death.

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