Non-invasive ventilation in acute respiratory failure of patients with obesity hypoventilation syndrome

2019 ◽  
Vol 109 (6 Suppl 1) ◽  
Author(s):  
Antonello Nicolini ◽  
Matteo Ferrando ◽  
Paolo Solidoro ◽  
Fabiano Di Marco ◽  
Fabrizio Facchini ◽  
...  
2018 ◽  
Vol 12 (1) ◽  
pp. 5
Author(s):  
Maurizio Alessandro Cavalleri ◽  
Elena Barbagelata ◽  
Marco Scudeletti ◽  
Antonello Nicolini

Non-invasive ventilation (NIV) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades compared to prior decades; nevertheless, NIV can have failure rates ranging from 5% to 50%. However, there are particular groups of patients that are more likely to benefit from NIV. One of these groups is patients with hypoventilation syndrome (OHS). The aim of this review is to seek evaluation of the effectiveness of NIV in acute setting. Only a few studies have investigated NIV success or failure in OHS patients. More than 30% of them were diagnosed when hospitalized for ARF. NIV rarely failed in reversing ARF. OHS patients who exhibited early NIV failure had a high severity score and a low HCO3 level at admission; more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV. Patients with decompensation of OHS have a better prognosis and response to NIV than other hypercapnic patients. They require more aggressive NIV settings, a longer time to reduce PaCO2 levels, and more frequently a delayed but successful response to NIV.


Respirology ◽  
2012 ◽  
Vol 17 (8) ◽  
pp. 1269-1274 ◽  
Author(s):  
OLALLA CASTRO-AÑÓN ◽  
RAFAEL GOLPE ◽  
LUIS A. PÉREZ-DE-LLANO ◽  
MARÍA JESÚS LÓPEZ GONZÁLEZ ◽  
EDGAR J. ESCALONA VELASQUEZ ◽  
...  

2007 ◽  
Vol 101 (6) ◽  
pp. 1191-1195 ◽  
Author(s):  
Stefania Redolfi ◽  
Luciano Corda ◽  
Giuseppe La Piana ◽  
Sara Spandrio ◽  
Paola Prometti ◽  
...  

2018 ◽  
Vol 54 (9) ◽  
pp. 455-459 ◽  
Author(s):  
Ramón Fernández Álvarez ◽  
Gemma Rubinos Cuadrado ◽  
Ines Ruiz Alvarez ◽  
Tamara Hermida Valverde ◽  
Marta Iscar Urrutia ◽  
...  

Author(s):  
Rajat Agarwal ◽  
Rishi Kumar Saini ◽  
Aseem Rajpal ◽  
Rajesh Agrawal ◽  
Amit Kumar

Background: Recent times have seen the rise in obstructive sleep apnea syndrome/obesity hypoventilation syndrome (OSAS/OHS) patients across the globe. Availability of sleep study centers, questionnaires, and more awareness have made the diagnosis of OSAS/OHS early. But still, the majority of patients suffer from morbidity associated with OSAS/OHS despite the better diagnosis, the most common cause being non-adherence to (CPAP). This needs to be addressed more vigilantly and with utmost importance for successful management of OSAS/OHS.Methods: This is an observational study, we selected patients by reviewing sleep study records at a tertiary care center (Rohilkhand medical college and hospital) in Bareilly, India. All diagnosed patients with OSAS/OHS (i.e. AHI >5) were telephoned and enquired about symptoms and non-invasive ventilation (NIV) use. They were evaluated using a self-designed questionnaire.Results: In our study, we had total of 49 OSAS/OHS patients with mean age of 50.6 years and mean BMI of 35.63. Male patients were 37 (75.5%) and at the time of diagnosis AHI (mean) was 60.67 events/hour. In NIV users there were 24 patients (48.97%), 22 patients (91.7%) feel they have been benefitted from CPAP and 2 patients (8.3%) do not feel benefit from CPAP (NIV) use. Among NIV users there was significant drop of AHI (mean) to 8.07. Among NIV users there was a reduction in symptoms like excessive day time sleepiness in 18 patients (81.81%), witnessed apnea in 15 patients (88.23%), snoring in 21 patients (91.30%), blood pressure in 3 patients (21.42%), blood sugar levels in 2 patients (20%), morning headache in 5 patients (83.30%), depressive mood in 2 patients (40%), perceived memory loss in 3 patients (33.3%), sense of choking in 17 patients (94.4%) and weight loss in 19 patients (76%).Conclusions: CPAP significantly improves symptoms and provides objective as well as subjective benefit to OSAS/OHS patients but still significant proportion of patients hesitate to initiate the therapy. Poor education/awareness regarding OSAS/OHS and non-availability of affordable CPAP remains the leading cause of non-compliance. There is a need for early education, reinforcement and affordable CPAP therapy.


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