title: The Effect of Supplemental Oxygen in Obesity Hypoventilation Syndrome.
abstract: Low flow supplemental oxygen is commonly prescribed to patients with obesity hypoventilation syndrome (OHS). However, there is a paucity of data regarding its efficacy and safety. The objective of this study was to assess the medium-term treatment efficacy of adding supplemental oxygen therapy to commonly prescribed treatment modalities in OHS.
  
  
  
  In thispost hocanalysis of a previous randomized controlled trial, we studied 302 sequentially screened OHS patients who were randomly assigned to noninvasive ventilation, continuous positive airway pressure, or lifestyle modification. Outcomes at 2 mo included arterial blood gases, symptoms, quality of life, blood pressure, polysomnography, spirometry, 6-min walk distance, and hospital resource utilization. Statistical analysis comparing patients with and without oxygen therapy in the three treatment groups was performed using an intention-to-treat analysis.
  
  
  
  In the noninvasive ventilation group, supplemental oxygen reduced systolic blood pressure although this could be also explained by a reduction in body weight experienced in this group. In the continuous positive airway pressure group, supplemental oxygen increased the frequency of morning confusion. In the lifestyle modification group, supplemental oxygen increased compensatory metabolic alkalosis and decreased the apnea-hypopnea index during sleep. Oxygen therapy was not associated with an increase in hospital resource utilization in any of the groups.
  
  
  
  After 2 mo of follow-up, chronic oxygen therapy produced marginal changes that were insufficient to consider it, globally, as beneficial or deleterious. Because supplemental oxygen therapy did not increase hospital resource utilization, we recommend prescribing oxygen therapy to patients with OHS who meet criteria with close monitoring. Long-term studies examining outcomes such as incident cardiovascular morbidity and mortality are necessary.
  
  
  
  Clinicaltrial.gov, ID: NCT01405976.
authors: San Pedro de Alcántara Hospital, Cáceres, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Juan F
authors: JF
authors: Masa
authors: San Pedro de Alcántara Hospital, Cáceres, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Jaime
authors: J
authors: Corral
authors: Virgen del Rocío Hospital, Sevilla, Spain.
authors: Auxiliadora
authors: A
authors: Romero
authors: Virgen del Rocío Hospital, Sevilla, Spain.
authors: Candela
authors: C
authors: Caballero
authors: University Hospital, Burgos, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Joaquin
authors: J
authors: Terán-Santos
authors: University Hospital, Burgos, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Maria L
authors: ML
authors: Alonso-Álvarez
authors: IIS Fundación Jiménez Díaz, Madrid, Spain.
authors: Teresa
authors: T
authors: Gomez-Garcia
authors: Valdecilla Hospital, Santander, Spain.
authors: Mónica
authors: M
authors: González
authors: Gregorio Marañon Hospital, Madrid, Spain.
authors: Soledad
authors: S
authors: López-Martínez
authors: Gregorio Marañon Hospital, Madrid, Spain.
authors: Pilar
authors: P
authors: De Lucas
authors: Miguel Servet Hospital, Zaragoza, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: José M
authors: JM
authors: Marin
authors: Valld'Hebron Hospital, Barcelona, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Sergi
authors: S
authors: Marti
authors: Doce de Octubre Hospital, Madrid, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Trinidad
authors: T
authors: Díaz-Cambriles
authors: San Juan Hospital, Alicante, Spain.
authors: Eusebi
authors: E
authors: Chiner
authors: San Pedro de Alcántara Hospital, Cáceres, Spain.
authors: Miguel
authors: M
authors: Merchan
authors: Sleep Unit, Respiratory Department, Alava University Hospital IRB, Vitoria, Spain.|CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain.
authors: Carlos
authors: C
authors: Egea
authors: Department of Physiology, University of Valladolid, Spain.
authors: Ana
authors: A
authors: Obeso
authors: Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, IL.
authors: Babak
authors: B
authors: Mokhlesi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis / Q000706:statistics & numerical data; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010845:Obesity Hypoventilation Syndrome / Q000628:therapy*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D017286:Polysomnography / Q000706:statistics & numerical data; D011788:Quality of Life; D013030:Spain; D013147:Spirometry / Q000706:statistics & numerical data; D016896:Treatment Outcome; D016138:Walking / Q000706:statistics & numerical data; D055815:Young Adult
keywords: noninvasive ventilation; obesity hypoventilation syndrome; oxygen therapy; sleep apnea