Treatment options for obesity hypoventilation syndrome

Recommended treatment for OHS patients include: a controlled weight loss program1; and nocturnal positive airway pressure, that is, noninvasive ventilation (NIV).2

Weight loss

Because weight is a major cause of OHS, the first step in treating patients suspected of OHS is weight loss. Losing weight will not only improve their general health, but can also improve alveolar ventilation [PaCO2] and arterial oxygen tension [PaO2].3

As well as following a weight loss program, patients should be monitored through: 

  • arterial blood gases testing
  • pulmonary function testing
  • a Polysomnography
  • chest radiographs.

Noninvasive ventilation (NIV)

The main goals of treatment for an OHS patient are to:

  • normalise arterial carbon dioxide tension (PaCO2 45 mmHg)
  • prevent hypoxemia during sleep and wakefulness
  • prevent erythrocytosis, pulmonary hypertension, and respiratory failure
  • relieve hypersomnia and altered mentation.

Treatment with NIV achieves these goals and has been widely observed to be the effective treatment for OHS.2

References

  • 01

    Piper JP, Grunstein RR. Obesity hypoventilation syndrome. (2011) Am J Respir Crit Care Med 183:292-298.

  • 02

    Storre JH, Seuthe B, Fiechter R, Milioglou S, Dreher M, Sorichter S, Windisch W. Average volume-assured pressure support in obesity hypoventilation: A randomised crossover trial. Chest.2006 Sep 130(3): 815-21.

  • 03

    Zavorsky GS, Hoffman SL. Pulmonary gas exchange in the morbidly obese. Obes Rev 2008 9:326-3 39.

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