title: Obesity hypoventilation syndrome: a review of epidemiology, pathophysiology, and perioperative considerations.
abstract: Obesity hypoventilation syndrome (OHS) is defined by the triad of obesity, daytime hypoventilation, and sleep-disordered breathing without an alternative neuromuscular, mechanical, or metabolic cause of hypoventilation. It is a disease entity distinct from simple obesity and obstructive sleep apnea. OHS is often undiagnosed but its prevalence is estimated to be 10-20% in obese patients with obstructive sleep apnea and 0.15-0.3% in the general adult population. Compared with eucapnic obese patients, those with OHS present with severe upper airway obstruction, restrictive chest physiology, blunted central respiratory drive, pulmonary hypertension, and increased mortality. The mainstay of therapy is noninvasive positive airway pressure. Currently, information regarding OHS is extremely limited in the anesthesiology literature. This review will examine the epidemiology, pathophysiology, clinical characteristics, screening, and treatment of OHS. Perioperative management of OHS will be discussed last.
authors.affiliation: Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Edmond H L
authors.initials: EH
authors.lastname: Chau
authors.forename: David
authors.initials: D
authors.lastname: Lam
authors.forename: Jean
authors.initials: J
authors.lastname: Wong
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
authors.forename: Frances
authors.initials: F
authors.lastname: Chung
mesh_terms: D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D010845:Obesity Hypoventilation Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D019990:Perioperative Care; D015995:Prevalence; D011651:Pulmonary Artery / Q000502:physiology; D015656:Respiratory Mechanics; D015431:Weight Loss