The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation.
OBJECTIVE
To assess the effectiveness of nasal noninvasive mechanical ventilation (NIMV) in patients with obesity hypoventilation syndrome (OHS).


METHODS
Clinical assay that compares two groups of patients with hypercapnic respiratory failure, one group with OHS and the other group with kyphoscoliosis, in their basal situation and after 4 months of treatment with nocturnal NIMV. Thirty-six patients (22 patients with OHS and 14 patients with kyphoscoliosis) completed the study protocol.


RESULTS
The frequency of symptoms, such as morning headache, morning drowsiness, dyspnea, and leg edema, improved in a statistically significant way in both groups of patients. The sleepiness improved only in the group with OHS. The comparison of frequency of symptoms between both groups of patients after NIMV treatment did not present statistically significant differences. In the resting situation and without nasal ventilation in place, the PO(2) (mean +/- SD) changed from 51 +/- 10 to 64 +/- 11 mm Hg (p < 0.001) and PCO(2) from 58 +/- 10 to 45 +/- 5 mm Hg (p < 0.001) when the patients with OHS were treated with NIMV. In the group of patients with kyphoscoliosis, likewise without nasal ventilation in place, PO(2) changed from 53 +/- 6 to 65 +/- 5 mm Hg (p < 0.001) and PCO(2) from 59 +/- 11 to 45 +/- 4 mm Hg (p < 0.001) with NIMV treatment. When we compared PO(2) and PCO(2) in both groups of patients at the beginning and at the end of NIMV treatment, we did not find statistically significant differences between OHS and kyphoscoliosis.


CONCLUSIONS
NIMV improves the clinical symptoms and the respiratory failure of patients with OHS to a similar degree to that reported for diseases in which its use is completely established, such as kyphoscoliosis. Therefore, NIMV could be an alternative to the treatment of patients with OHS.
Masa
J F
JF
Pulmonary Division, San Pedro de Alcántara Hospital, Cáceres, Spain. fmasa@separ.es
Celli
B R
BR
Riesco
J A
JA
Hernández
M
M
Sánchez De Cos
J
J
Disdier
C
C
D000328:Adult; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000628:therapy; D007040:Hypoventilation / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D007738:Kyphosis / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D015656:Respiratory Mechanics; D012600:Scoliosis / Q000150:complications / Q000503:physiopathology; D013147:Spirometry; D013577:Syndrome
D002245:Carbon Dioxide; D010100:Oxygen