scholarly journals Acute Respiratory Failure in Obesity-Hypoventilation Syndrome Managed in the ICU

2019 ◽  
Vol 64 (12) ◽  
pp. 1545-1554
Author(s):  
Nader Chebib ◽  
Pascale Nesme ◽  
Nathalie Freymond ◽  
Laurent Argaud ◽  
Thomas Rimmelé ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Obesity Hypoventilation Syndrome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

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 ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Ventilation ◽  
Obesity Hypoventilation Syndrome ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

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.

scholarly journals 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 ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Obesity Hypoventilation Syndrome ◽  
Hypercapnic Respiratory Failure ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation ◽  
Disordered Breathing

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.

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