Haemodynamic effects of non-invasive ventilation in patients with obesity-hypoventilation syndrome.
Summary of "Haemodynamic effects of non-invasive ventilation in patients with obesity-hypoventilation syndrome."
SUMMARY AT A
The haemodynamic effects of non-invasive ventilation (NIV) have not been investigated in patients with obesity-hypoventilation syndrome (OHS). Right ventricular overload is frequent found in patients with severe OHS. This study has shown that NIV for six months had a beneficial effect on the haemodynamic status of these patients.
Background and objective: Although it has been reported that pulmonary hypertension (PH) is more frequent in patients with obesity-hypoventilation syndrome (OHS) than in patients with "pure" obstructive sleep apnoea syndrome, little is known about the haemodynamic repercussions of this entity. The aim was to describe the haemodynamic status, as assessed by echocardiography and six-minute walk test (6MWT), of patients with a newly diagnosed, most severe form of OHS, and to evaluate the impact of non-invasive ventilation (NIV) in these patients. Methods: A prospective, descriptive, single-centre follow-up study was conducted. At baseline, patients underwent echocardiography, spirometry, static lung volume measurement, 6MWT, overnight pulse-oximetry and polygraphic recording. Changes in echocardiography and 6MWT were assessed after six months of NIV. Right ventricular overload (RVO) was defined on the basis of right ventricular dilatation, hypokinesis, paradoxical septal motion and/or PH. Results: Thirty patients (20 women; mean age 69±11 years) were tested. The percentage of patients with RVO did not change significantly after NIV (43.3% to 41.6%; P= 0.24). In patients with RVO at diagnosis, pulmonary artery systolic pressure (PSAP) decreased significantly at six months (58±11 to 44±12 mmHg; P=0.014) and mean distance on 6MWT increased from 350±110 to 426±78 m (P=0.006), without significant changes in body mass index. Conclusions: RVO is a frequent finding in patients with the most severe form of OHS. Treatment with NIV is associated with a decrease in PASP and an increase in the distance covered during the 6MWT. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Respiratory Division and Sleep Disorders Unit Cardiology Service, Hospital Lucus Augusti, Lugo, Department of Internal Medicine, University of Santiago of Compostela, Santiago de Compostela, Spain.
This article was published in the following journal.
Name: Respirology (Carlton, Vic.)
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22897169
- DOI: http://dx.doi.org/10.1111/j.1440-1843.2012.02252.x
Medical and Biotech [MESH] Definitions
Obesity Hypoventilation Syndrome
HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.
Agents that increase energy expenditure and weight loss by neural and chemical regulation. Beta-adrenergic agents and serotoninergic drugs have been experimentally used in patients with non-insulin dependent diabetes mellitus (NIDDM) to treat obesity.
Hydatidiform Mole, Invasive
A uterine tumor derived from persistent gestational TROPHOBLASTS, most likely after a molar pregnancy (HYDATIDIFORM MOLE). Invasive hyadatiform mole develops in about 15% of patients after evacuation of a complete mole and less frequently after other types of gestation. It may perforate the MYOMETRIUM and erode uterine vessels causing hemorrhage.
A condition of having excess fat in the abdomen. Abdominal obesity is typically defined as waist circumferences of 40 inches or more in men and 35 inches or more in women. Abdominal obesity raises the risk of developing disorders, such as diabetes, hypertension and METABOLIC SYNDROME X.
Ventilatory support system using frequencies from 60-900 cycles/min or more. Three types of systems have been distinguished on the basis of rates, volumes, and the system used. They are high frequency positive-pressure ventilation (HFPPV); HIGH-FREQUENCY JET VENTILATION; (HFJV); and high-frequency oscillation (HFO).
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