Polysomnography Improves the Success Rate of Noninvasive Ventilation in Obesity Hypoventilation Syndrome Complicated With Respiratory Failure and Heart Failure

CHEST Journal ◽  
2016 ◽  
Vol 149 (4) ◽  
pp. A561
Author(s):  
Mengge Wang ◽  
Songyun Ouyang ◽  
Jiao Su ◽  
Peizong Sun ◽  
Linge Sun ◽  
...  
2016 ◽  
Vol 32 (7) ◽  
pp. 421-428 ◽  
Author(s):  
Telma C. A. Sequeira ◽  
Ahmed S. BaHammam ◽  
Antonio M. Esquinas

Obesity is a global epidemic that adversely affects respiratory physiology. Sleep-disordered breathing and obesity hypoventilation syndrome (OHS) are among the most common pulmonary complications related to obesity class III. Patients with OHS may present with acute hypercapnic respiratory failure (AHRF) that necessitates immediate noninvasive ventilation (NIV) or invasive ventilation and intensive care unit (ICU) monitoring. The OHS is underrecognized as a cause of AHRF. The management of mechanical ventilation in obese ICU patients is one of the most challenging problems facing respirologists, intensivists, and anesthesiologists. The treatment of AHRF in patients with OHS should aim to improve alveolar ventilation with better alveolar gas exchange, as well as maintaining a patent upper airway, which is ideally achieved through NIV. Treatment with NIV is associated with improvement in blood gases and lung mechanics and may reduce hospital admissions and morbidity. In this review, we will address 3 main issues: (1) NIV of critically ill patients with acute respiratory failure and OHS; (2) the indications for postoperative application of NIV in patients with OHS; and (3) the impact of OHS on weaning and postextubation respiratory failure. Additionally, the authors propose an algorithm for the management of obese patients with AHRF.


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Shengyu Hao ◽  
Lingling Pang ◽  
Liang Xie ◽  
Xu Wu ◽  
Zilong Liu ◽  
...  

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.


CHEST Journal ◽  
2012 ◽  
Vol 141 (3) ◽  
pp. 692-702 ◽  
Author(s):  
Jean-Christian Borel ◽  
Renaud Tamisier ◽  
Jesus Gonzalez-Bermejo ◽  
Jean-Philippe Baguet ◽  
Denis Monneret ◽  
...  

1982 ◽  
Vol 63 (3) ◽  
pp. 48-51
Author(s):  
V. I. Zhukov

Obesity, as you know, is often combined with atherosclerosis, hypertension and their characteristic left-heart failure. Least of all, in our opinion, obesity is associated with cor pulmonale and right-heart failure. "Pickwick syndrome", it is also known as "Ioe syndrome", "cardiopulmonary syndrome of patients with obesity", "obesity-hypoventilation syndrome".


2019 ◽  
Vol 28 (151) ◽  
pp. 180097 ◽  
Author(s):  
Juan F. Masa ◽  
Jean-Louis Pépin ◽  
Jean-Christian Borel ◽  
Babak Mokhlesi ◽  
Patrick B. Murphy ◽  
...  

Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥30 kg·m−2), daytime hypercapnia (arterial carbon dioxide tension ≥45 mmHg) and sleep disordered breathing, after ruling out other disorders that may cause alveolar hypoventilation. OHS prevalence has been estimated to be ∼0.4% of the adult population. OHS is typically diagnosed during an episode of acute-on-chronic hypercapnic respiratory failure or when symptoms lead to pulmonary or sleep consultation in stable conditions. The diagnosis is firmly established after arterial blood gases and a sleep study. The presence of daytime hypercapnia is explained by several co-existing mechanisms such as obesity-related changes in the respiratory system, alterations in respiratory drive and breathing abnormalities during sleep. The most frequent comorbidities are metabolic and cardiovascular, mainly heart failure, coronary disease and pulmonary hypertension. Both continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) improve clinical symptoms, quality of life, gas exchange, and sleep disordered breathing. CPAP is considered the first-line treatment modality for OHS phenotype with concomitant severe obstructive sleep apnoea, whereas NIV is preferred in the minority of OHS patients with hypoventilation during sleep with no or milder forms of obstructive sleep apnoea (approximately <30% of OHS patients). Acute-on-chronic hypercapnic respiratory failure is habitually treated with NIV. Appropriate management of comorbidities including medications and rehabilitation programmes are key issues for improving prognosis.


Respiration ◽  
2017 ◽  
Vol 93 (3) ◽  
pp. 162-169 ◽  
Author(s):  
Ramon Fernandez Alvarez ◽  
Claudio Rabec ◽  
Gemma Rubinos Cuadrado ◽  
Juan Alejandro Cascon Hernandez ◽  
Patricia Rodriguez ◽  
...  

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