Evaluation and Management of Obesity Hypoventilation Syndrome
Publication Date: August 1, 2019
Key Points
Key Points
- Obesity hypoventilation syndrome (OHS) is defined by the combination of obesity (body mass index [BMI] ≥30 kg/m2), sleep-disordered breathing (SDB) and awake daytime hypercapnia (awake resting partial pressure of arterial CO2 or PaCO2 ≥45 mmHg at sea level), after excluding other causes for hypoventilation.
- OHS is the most severe form of obesity-induced respiratory compromise and leads to serious sequelae, including increased rates of mortality, chronic heart failure, pulmonary hypertension, and hospitalization due to acute-on-chronic hypercapnic respiratory failure, among others.
- While the definition of OHS suggests a diurnal pathology, polysomnography or sleep respiratory polygraphy is required to determine the pattern of SDB and hypoventilation (obstructive or non-obstructive), to tailor treatment, and to establish the optimal settings of positive airway pressure (PAP) therapy.
- PAP has become the primary management option for controlling SDB and reversing awake hypoventilation in patients with OHS.
Evaluation
Evaluat...
...ry Guideline FlowchartFlowchart summarizing the...
Management
Managem...
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...atients with low to moderate probability of hav...
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...stable ambulatory patients diagnosed with...
...table ambulatory patients diagnosed with...
...: The ATS suggests that hospitalized patient...
...patients with OHS the ATS suggests using we...