Noninvasive Ventilation in Obesity Hypoventilation Syndrome. Short- and Long-Term Outcomes

Abstract Background Malignant obesity hypoventilation syndrome (MOHS) is described as a subtype condition of OHS, characterized by extreme obesity, obese-related hypoventilation, and multiorgan dysfunction. Because of low awareness and inadequate treatment, MOHS leads to high morbidity and mortality. Case presentation A 53-year-old man was diagnosed with MOHS evidenced by extreme obesity and multiorgan abnormalities. After taken noninvasive ventilation (NIV) treatment, he was rescued. And at the end of the six-month pulmonary rehabilitation (PR) program, improvement in terms of respiratory parameters, BMI, apnea-hypopnea index (AHI), and pulmonary hypertension were observed in the patient. Two years later, the patient was still in good condition. Conclusions This case highlights the awareness and proper use of NIV to rescue MOHS patients. Furthermore, the benefits of PR were explored in this case, which has not been considered within the therapeutic options for MOHS patients.

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Noninvasive Ventilation in Mild Obesity Hypoventilation Syndrome

CHEST Journal ◽

10.1378/chest.10-2531 ◽

2012 ◽

Vol 141 (3) ◽

pp. 692-702 ◽

Cited By ~ 90

Author(s):

Jean-Christian Borel ◽

Renaud Tamisier ◽

Jesus Gonzalez-Bermejo ◽

Jean-Philippe Baguet ◽

Denis Monneret ◽

...

Keyword(s):

Noninvasive Ventilation ◽

Obesity Hypoventilation Syndrome ◽

Hypoventilation Syndrome ◽

Obesity Hypoventilation ◽

Mild Obesity

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Gender differences in patients starting long-term home mechanical ventilation due to obesity hypoventilation syndrome

Respiratory Medicine ◽

10.1016/j.rmed.2015.11.010 ◽

2016 ◽

Vol 110 ◽

pp. 73-78 ◽

Cited By ~ 17

Author(s):

Andreas Palm ◽

Bengt Midgren ◽

Christer Janson ◽

Eva Lindberg

Keyword(s):

Gender Differences ◽

Mechanical Ventilation ◽

Obesity Hypoventilation Syndrome ◽

Home Mechanical Ventilation ◽

Hypoventilation Syndrome ◽

Obesity Hypoventilation

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Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea

Thorax ◽

10.1136/thoraxjnl-2019-213622 ◽

2020 ◽

Vol 75 (6) ◽

pp. 459-467 ◽

Cited By ~ 4

Author(s):

Juan F Masa ◽

Babak Mokhlesi ◽

Iván Benítez ◽

Francisco Javier Gómez de Terreros Caro ◽

M-Ángeles Sánchez-Quiroga ◽

...

Keyword(s):

Cost Effectiveness ◽

Primary Outcome ◽

Cost Effective ◽

Sleep Apnoea ◽

Obesity Hypoventilation Syndrome ◽

Obstructive Sleep ◽

The Mean ◽

Hypoventilation Syndrome ◽

Obesity Hypoventilation

BackgroundObesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities.ObjectivesWe performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure.MethodsHospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed.ResultsIn total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91–3.14) years for NIV group and 3.00 (2.92–3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups.ConclusionCPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA.Trial registration numberNCT01405976

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