Chest
ORIGINAL RESEARCHSLEEP MEDICINELong-Term Outcome of Noninvasive Positive Pressure Ventilation for Obesity Hypoventilation Syndrome
Section snippets
Population
All patients with OHS consecutively discharged with NPPV from the Department of Respiratory Medicine of Angers University Hospital between January 1995 and December 2006 were included in the study. OHS was diagnosed according to the current definition by BMI ≥ 30 kg/m2 and daytime hypercapnia (Paco2 > 45 mm Hg) in the absence of any other cause of hypoventilation on the basis of clinical examination, chest radiograph, and pulmonary function tests (eg, COPD [FEV1 to vital capacity ratio < 70%]).1
Study Population and NPPV Technique
A total of 130 patients (56 women and 74 men) with OHS discharged with NPPV between January 1995 and December 2006 were included. NPPV had been initiated under stable clinical conditions for 92 (71%) patients and during ICU management of an acute exacerbation for 38 (29%) patients, six of whom required invasive mechanical ventilation prior to NPPV. The mean NPPV prescription rate for OHS was 5.8 patients per year from 1995 to 1999 and 14.4 patients per year from 2000 to 2006. The increased NPPV
Discussion
This study evaluated the long-term outcome of NPPV in a large sample of patients with OHS with a follow-up of up to 10 years. As previously described,7 a marked increase in NPPV prescriptions for OHS was observed during the study period that may reflect growth of the obesity epidemic but also a better knowledge by primary care and chest physicians of the consequences of obesity on respiratory function and the beneficial effects of NPPV in this population. Except for a lower baseline ESS,
Acknowledgments
Author contributions: Dr Priou: contributed to conception and design; acquisition, analysis and interpretation of data; and drafting the submitted article; and provided final approval of the version to be published.
Dr Hamel: contributed to analysis and interpretation of data; critical revision of the submitted article for important intellectual content; and provided final approval of the version to be published.
Dr Person: contributed to conception, design, and interpretation of data; critical
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