[Effect of noninvasive ventilation on work of breathing in obesity].
BACKGROUND
Noninvasive ventilation with nose- or face-masks has been increasingly used in the past. The objective of mechanical ventilation is in addition to improve gas exchange to reduce breathing work. While improvement on breathing work has been shown mainly on normal-weight patients with different respiratory diseases, there is no existing data about the effect of noninvasive ventilation on the breathing work of patients with massive obesity.


METHODS
Assisted mask-ventilation with bilevel positive airway pressure (BiPAP) was carried out on 5 overweight control subjects (overweight controls), 7 overweight patients with obstructive sleep apnea (OSA), 6 patients with obesitas-hypoventilation syndrome (OHS), and 7 overweight patients with chronic obstructive lung disease (COLD). Inspiratory pressure assist (IPAP) was set to 12 or 16 cm H2O, exspiratory pressure (EPAP) was set to 5 cm H2O. All, subjects were massive overweight (body mass index [BMI] 42.2 +/- 5.8; range 31.8 to 55.4 kg/m2). Respiratory muscle activity was measured as esophageal pressure change (delta Pes) and transdiaphragmatic pressure change (delta Pdi) and calculated as pressure time integral.


RESULTS
With noninvasive ventilation respiratory muscle activity was significantly (p < 0.05) reduced in all groups at least 40% compared to baseline values during spontaneous respiration.


CONCLUSIONS
Noninvasive ventilation via face masks can efficiently reduce work of breathing in subjects with massive obesity.
Pankow
W
W
Medizinische Poliklinik, Schlafmedizinisches Labor, Klinikum der Philipps-Universität Marburg.
Hijjeh
N
N
Schüttler
F
F
Penzel
T
T
Peter
J H
JH
von Wichert
P
P
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000503:physiopathology; D014939:Work of Breathing / Q000502:physiology*
Der Einfluss der nichtinvasiven Beatmung auf die Atemarbeit bei Adipösen.