scholarly journals Long-term Noninvasive Ventilation in Obesity Hypoventilation Syndrome Without Severe OSA

CHEST Journal ◽  
2020 ◽  
Vol 158 (3) ◽  
pp. 1176-1186
Author(s):  
Juan F. Masa ◽  
Iván Benítez ◽  
Maria Á. Sánchez-Quiroga ◽  
Francisco J. Gomez de Terreros ◽  
Jaime Corral ◽  
...  
Keyword(s):  
Noninvasive Ventilation ◽  
Obesity Hypoventilation Syndrome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

2020 ◽  
Author(s):  
Mª Ángeles Sanchez Quiroga ◽  
Juan Fernando Masa Jiménez ◽  
Ivan Benitez ◽  
Javier Gómez De Terreros ◽  
Jaime Corral ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Noninvasive Ventilation ◽  
Sleep Apnoea ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

scholarly journals Case report: fast reversal of malignant obesity hypoventilation syndrome after noninvasive ventilation and pulmonary rehabilitation

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Shengyu Hao ◽  
Lingling Pang ◽  
Liang Xie ◽  
Xu Wu ◽  
Zilong Liu ◽  
...  
Keyword(s):  
Noninvasive Ventilation ◽  
Pulmonary Rehabilitation ◽  
Good Condition ◽  
Program Improvement ◽  
Apnea Hypopnea Index ◽  
High Morbidity ◽  
Obesity Hypoventilation Syndrome ◽  
Extreme Obesity ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

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.

Noninvasive Ventilation in Mild Obesity Hypoventilation Syndrome

CHEST Journal ◽  
2012 ◽  
Vol 141 (3) ◽  
pp. 692-702 ◽  
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

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

Thorax ◽  
2020 ◽  
Vol 75 (6) ◽  
pp. 459-467 ◽  
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

Noninvasive Ventilation in the Critically Ill Patient With Obesity Hypoventilation Syndrome: A Review

2016 ◽  
Vol 32 (7) ◽  
pp. 421-428 ◽  
Author(s):  
Telma C. A. Sequeira ◽  
Ahmed S. BaHammam ◽  
Antonio M. Esquinas
Keyword(s):  
Respiratory Failure ◽  
Critically Ill ◽  
Noninvasive Ventilation ◽  
Hospital Admissions ◽  
Lung Mechanics ◽  
Critically Ill Patient ◽  
Obesity Hypoventilation Syndrome ◽  
Hypoventilation Syndrome ◽  
The Impact ◽  
Obesity Hypoventilation

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.

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