Obesity Hypoventilation Syndrome

Balachandran, Jay S.; Masa, Juan F.; Mokhlesi, Babak

doi:10.1016/j.jsmc.2014.05.007

Cited by 131 publications

(88 citation statements)

References 41 publications

(67 reference statements)

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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%

“…The exact prevalence of OHS in the community is unclear, but is estimated to be approximately 0.15-0.6% of the general population [6]. OHS is seen much more commonly in sleep disorders clinics, with estimated prevalence ranging from 9 to 20% of referred obese patients, and as high as 42% of referred patients with a BMI more than 35 kg/m 2 [7,8 && ].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Key Pointsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Obesity hypoventilation syndrome

Pierce,

Brown

2015

Current Opinion in Pulmonary Medicine

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“…The patients respond by making marks on the scale. The scoring for items 1,3,5,6,8,10,11,13 is in the form of 3, 2, 1, 0. Items 2, 4, 7, 9, 12, 14 are scored as 0, 1, 2, 3.…”

Section: Methodsmentioning

confidence: 99%

“…Excessive daytime sleepiness, witnessed apnea and snoring generally suggest two kinds of disorders known as the sleep apnea syndrome (SAS) and the obesity-hyperventilation syndrome 1 . SAS is a common disorder in the population.…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of the Relationships Between Sleep Apnea Syndrome and Depression/Anxiety Disorder

Ehi¹,

Yücetaş²,

Yenilmez³

et al. 2016

Kafkas J Med Sci

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“…Il affecte 4 à 50 % des patients, et cette pré-valence augmente avec le degré de sévérité de l'obésité [34]. Il s'accompagne d'un risque de 18 à 31 % d'hypoventilation alvéolaire avec hypoxémie chez les sujets ayant un IMC supérieur ou égal à 40 kg/m 2 [34]. La prise en compte de cette hypoxémie lors de la prescription de médicaments favorisant une dépression respiratoire est évidente.…”

Section: Complications De L'obésitéunclassified

Adaptation posologique chez le sujet obèse

Lloret‐Linares

Hachon

2015

Réanimation

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Reçu le 23 janvier 2015 ; accepté le 21 mai 2015 © SRLF et Lavoisier SAS 2015Résumé L'excès pondéral, du fait de sa prévalence et de ses comorbidités multiples, est tel que nous soignons de plus en plus de patients obèses, nous incitant à nous interroger sur le juste dosage des médicaments. Dans cette mise au point sont abordées les modifications physiologiques liées à l'obésité et les modifications de pharmacocinétique associées, notamment du fait de modifications de distribution et de métabo-lisme des médicaments. Dans la plupart des situations, il n'existe pas de recommandations particulières concernant l'adaptation des doses des médicaments chez les sujets obè-ses. Une prescription off-label en l'absence de recommandations peut être envisagée si elle est suffisamment documentée. Elle doit cependant rester prudente, car les modifications physiologiques associées à l'obésité n'impliquent pas néces-sairement un risque de sous-dosage. Mots clés Obésité · Pharmacocinétique · Métabolisme · Adaptation des dosesAbstract The excess of body-weight, by its prevalence and its associated-complications, explain that more and more obese patients are treated, encouraging a reflexion about dosing consideration. In this review, we focus on the physiological changes linked with obesity and the associated changes in drug pharmacokinetics, especially as changes in drug distribution and metabolism occur. In many situations, no recommendation exists for adjusting drug dosage in obese subjects. An "off-label" prescription, when dosage recommendations are lacking, is possible if sufficiently documented. However it must remain careful, as physiological changes linked to obesity are not necessarily associated with a risk of drug under-dosing.

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Obesity Hypoventilation Syndrome

Cited by 131 publications

References 41 publications

Obesity hypoventilation syndrome

Obesity hypoventilation syndrome

The Evaluation of the Relationships Between Sleep Apnea Syndrome and Depression/Anxiety Disorder

Adaptation posologique chez le sujet obèse

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