Abstract
Background Although obesity hypoventilation syndrome (OHS) has become the most common indication for domiciliary Non-Invasive Ventilation (NIV) optimal treatment remains unclear.
Methods We undertook a 3 month randomised controlled trial of NIV (spontaneous-timed mode bi-level positive airway pressure – Bi-level PAP) vs CPAP for initial treatment of OHS and evaluated the impact on treatment failure (hospital admission, persistent ventilatory failure or non-compliance), quality of life and control of ventilatory failure.
Results 60 participants were randomised (29 Bi-level PAP and 31 CPAP, age 53 y (SD 10), BMI 55 kg/m2 (SD 12), PaCO2 60 mmHg (SD 14)). There was no difference between groups in treatment failure at 3 months (Bi-level PAP, 17.2% vs CPAP, 12.9%, p=0.65). Sleepiness (Epworth Sleepiness Scale (ESS)), quality of life (SF36 and Severe Respiratory Insufficiency questionnaire (SRI)), obesity and ventilatory failure improved in both groups (p<0.01 for all), however there was no difference between groups.
Conclusions CPAP and Bi-level PAP provided similar improvements in symptoms, quality of life and ventilatory failure for OHS after 3 months with no difference in treatment failure.
Supported By: The ResMed Foundation.
- © 2014 ERS