Chest
Clinical InvestigationsObesity And HypoventilationThe Obesity-Hypoventilation Syndrome Revisited: A Prospective Study of 34 Consecutive Cases
Section snippets
Materials and Methods
We included in this study 34 patients who were consecutively admitted to our department between 1991 and 1997. These patients met the criteria for obesity-hypoventilation: (1) hypoventilation defined by a Pao2 < 70 mm Hg and a Paco2 > 45 mm Hg by diurnal blood gas analysis at rest, and (2) obesity with a body mass index (BMI)> 30 kg/m2.
Patients were excluded if the impairment of gas exchange could be explained by any other cause. Therefore, we excluded patients with COPD when they showed an
Results
Among the 34 patients with OHS, mean age was 61 ± 11 years; 9 patients were women. The average BMI was 40 ± 8 kg/m2, indicating severe obesity. Seventeen of 34 patients were smokers. While 13 patients were ex-smokers, 4 patients still continued smoking. Smoking duration was, on average, 35 ± 25 pack-years. Seven patients complained of chronic bronchitis. Half of the patients had been hospitalized for one or more times in an ICU before definitive diagnosis was made, and eight patients had been
Discussion
Our study highlights the impairment of gas exchange, which occurs in some patients with OSAS and an associated OHS or COPD. The deleterious effects on gas exchange of these associations can be observed even when the ventilatory defect is of mild-to-moderate degree, and would not induce per se respiratory insufficiency.
In a study published previously by our group,4 we examined patients with the association of OSAS plus COPD, and we showed that these patients had more gas exchange abnormalities
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