Defining obesity hypoventilation syndrome

Tulaimat, Aiman; Littleton, Stephen W.

doi:10.1136/thoraxjnl-2013-204992

Cited by 38 publications

(6 citation statements)

References 9 publications

(2 reference statements)

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“…Besides, SLC4A4 (the solute carrier family 4, sodium bicarbonate cotransporter member 4), the coherent target of miR-634, codes for an electrogenic Na(+), HCO(3) (−)-cotransporter (NBCe1), which is present in the basolateral membranes of proximal tubules and is responsible for the bicarbonate efflux there, and thus about 80% of the renal bicarbonate reabsorption [30]. Notably, abnormal bicarbonate metabolism was often found in the complications of obesity such as obesity hypoventilation syndrome [31]. The result of our study suggested that the interaction of hsa-miR-634 and SLC4A4 might influence the bicarbonate metabolism, thus playing a role in the network in obesity.…”

Section: Discussionmentioning

confidence: 99%

Global correlation analysis for microRNA and gene expression profiles in human obesity

Zhou

et al. 2015

Pathology - Research and Practice

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Section: Discussionmentioning

confidence: 99%

Global correlation analysis for microRNA and gene expression profiles in human obesity

Zhou

et al. 2015

Pathology - Research and Practice

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“…In conclusion, OHS is a common disease that is frequently misdiagnosed and mistreated and carries a high mortality . Serum bicarbonate greater than 27 mmol L −1 is a sensitive and inexpensive marker of established OHS as well as ‘early’ OHS; all patients with a BMI > 35 kg m −2 should be screened for OHS using this simple test . Patients with OHS should be referred to a pulmonary and/or sleep specialist for evaluation for NIPPV, to a dietician for dietary counseling and lifestyle modification and to a bariatric surgeon for evaluation for bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

The clinical characteristics and hospital and post‐hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort

Marik

Chen

2016

Obesity Science & Practice

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SummaryObjectiveThe worldwide prevalence of obesity has reached epidemic proportions. Obesity hypoventilation syndrome (OHS) is a common yet largely undiagnosed and mistreated condition that likely carries a high mortality. The aim of this study was to determine the clinical characteristics, hospital outcome, outcome following hospital discharge and predictors of death in a large cohort of patients hospitalized with OHS. OHS is an important condition as many patients with this syndrome are misdiagnosed and receive inappropriate treatment.MethodsWe reviewed the electronic medical records of patients with unequivocal OHS admitted to a 525‐bed tertiary‐care teaching hospital over a 5‐year period. Demographic and clinical data as well as hospital disposition were recorded. In order to determine the patients' post‐discharge status, we linked our database to the database of death certificates of the State Registrar of Vital Records.ResultsWe identified 600 patients who met the inclusion criteria for this study. The patients' mean age was 58 ± 15 years with a mean body mass index of 48.2 ± 8.3 kg m−2; 64% were women. Thirty‐seven percent had a history of diabetes and 43% had been misdiagnosed as having chronic obstructive pulmonary disease, while none had been previously diagnosed with OHS. The most common admission diagnoses were respiratory failure, heart failure and sepsis. Ninety (15%) patients died during the index hospitalization. The patients' age, S‐creatinine, respiratory failure, sepsis and admission to the ICU were independent predictors of hospital mortality. The hospital survivors were followed for a mean of 1,174 ± 501 d (3.2 ± 1.3 years) from the index hospitalization. On follow‐up, 98 of the 510 (19%) hospital survivors died, with an overall cumulative mortality of 31.3%. The patients' age, S‐creatinine and admission to the ICU were independent predictors of post‐hospital mortality.ConclusionObesity hypoventilation syndrome is a common disease that is frequently misdiagnosed and mistreated and carries a 3‐year morality, which is significantly worse than that for most cancers combined. Considering the high mortality of this disease, all patients with a body mass index > 35 kg m−2 should be screened for OHS; those patients with both early and established OHS should be referred to a pulmonary and/or sleep specialist for evaluation for non‐invasive positive pressure ventilation, to a dietician for dietary counseling and lifestyle modification and to a bariatric surgeon for evaluation for bariatric surgery.

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“…Not surprisingly, opinions are mixed and many have legitimate concerns about using calculated bicarbonate values derived from arterial blood draws. Using cutoff values of greater than 27 mEq/l, calculated bicarbonate from arterial blood gases has 90% sensitivity but perhaps only 50% specificity for making a diagnosis of OHS [24], making it a far better tool to rule out OHS rather than diagnose it (up to a 97% negative predictive value) [6]. In addition, Monneret questioned the reproducibility of base excess within individual patients and the variability that can occur when base excess is derived from different instruments, suggesting that calculated arterial standard bicarbonate is a slightly more reliable index [23].…”

Section: Key Pointsmentioning

confidence: 99%

Obesity hypoventilation syndrome

Pierce,

Brown

2015

Current Opinion in Pulmonary Medicine

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OHS is a complex multiorgan system disease process that appears to be driven by adaptive changes in respiratory physiology and compensatory changes in metabolic processes, both of which are ultimately counter-productive. The diurnal hypercapnia and hypoxia induce pathologic effects that further worsen sleep-related breathing, resulting in a slowly progressive worsening of disease. In addition, leptin resistance in obesity and OHS likely contributes to blunting of ventilatory drive and inadequate chemoreceptor response to hypercarbia and hypoxemia.

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Defining obesity hypoventilation syndrome

Cited by 38 publications

References 9 publications

Global correlation analysis for microRNA and gene expression profiles in human obesity

Global correlation analysis for microRNA and gene expression profiles in human obesity

The clinical characteristics and hospital and post‐hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort

Obesity hypoventilation syndrome

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