Chest
Clinical Investigations: Control of BreathingThe Obesity Hypoventilation Syndrome Can Be Treated With Noninvasive Mechanical Ventilation
Section snippets
Study Design
This clinical trial compared patients at baseline and after 4 months of treatment with NIMV. There were two groups of patients: one group with OHS and one group with kyphoscoliosis. The inclusion criteria for the patients with OHS were as follows: body mass index> 33, failure of dietetic treatment to induce weight loss with persistence of hypercapnic respiratory failure (Pco2 > 47 mm Hg) for at least 3 months before NIMV treatment, and refusal of surgical treatment of obesity based either on
Follow-up
Sixteen patients (73%) from the OHS group and 12 patients (86%) from the kyphoscoliotic group had been admitted to the hospital for respiratory failure at least once in the previous 3 years. During this time, the number (mean ± SD) of emergency visits per patient was 5.2 ± 2.1 visits for those in the OHS group and 4.6 ± 1.7 visits for those in the kyphoscoliotic group. Neither emergency visits nor hospitalizations occurred during the follow-up period. All the patients were receiving NIMV
Discussion
This study shows that NIMV is effective in alleviating the symptoms and reversing the respiratory failure of patients with OHS. The effect is similar to that seen in patients with kyphoscoliosis.
The mechanism by which OHS causes respiratory failure has not been well established, although a central component characterized by a defect in the respiratory controller appears to be the most important in causing it.9 A decreased ventilatory response to CO2 rebreathing has been generally observed.10 In
ACKNOWLEDGMENT
We are indebted to Verónica Rodríguez for assistance in the preparation of the article.
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This work was performed at “San Pedro de Alcántara” Hospital, Cáceres, Spain.