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OBESITY HYPOVENTILATION: CPAP OR BILEVEL SUPPORT
Obesity hypoventilation (OHS) is a significant clinical problem and associated with increased healthcare resource. OHS patients often develop respiratory failure, and in this month’s Thorax, Piper and colleagues report on a study comparing CPAP with bilevel ventilatory support as initial management. OHS patients with severe persisting nocturnal hypoxamia were excluded and then the remainder were randomised to one of the two interventions. Results showed no difference between the two therapies with respect to daytime hypercapnia which was the primary outcome, but patients on bilevel support reported better subjective sleep quality than those …