how to treat obesity hypoventilation syndrome
It is also known as pickwickian syndrome.It is a condition in which obese people have high level of carbon dioxide and very low level of oxygen in blood.This is due to very difficult breathing.Obesity creat sleeping -disordered respiratory problems that disturb patient day to day quality of life and its economic status.It is a syndrome in which overweight people under breath.The BMI of such people is greater than 30 kg/m2.It can be happen mostly at night when obese people suffer from sleep apnea in which they have difficulty in sleeping.There arterial Co2 tension is greater than 45 mmHg.Sleep apnea is considered as life threatening condition for the people with OHS.People with BMI more than 30 kg/m2 have more stress of their extra weight, their oxygen level remains low but their carbon dioxide level remain very high.Drop oxygen level constrict lung vessels,it became very difficult for the heart to pump into lungs for blood oxygenation.This produce more pressure in pulmonary artery cause pulmonary hypertension.Due to forced pumping into lungs ventricle of heart enlarged and possibility of heart failure increases.The patient with chronic obstructive pulmonary disease(COPD) have often raised CO2 levels ,so should be treated first,before diagnosing OHS. symptoms Most common symptoms appear at prognosis are snoring,ventilatory insufficiency with slow or stopped breathing,drowsiness and shortness of breath. Obstructive sleep apnea occur due to blocking of airways during sleep that sends an alarming signal to brain for reopening of airways that cause awakening during sleep. Body symptoms Swelling around ankles,wheezy chest with pain are common symptoms.These symptoms are in combination with obesity,apnea and hypercapnia(elevated carbon dioxide level in blood) Treatments The most suitable treatment is weight loss and non invasive positive air pressure(pap) is also very necessary.Continuous positive airway pressure device (CPAP) is a good method for non invasive positive air pressure and should be use for patient with sleep apnea.In sleep apnea,there is sleep-disordered breathing.Continuous positive pressure ventilation keep the throat open and boost the breath of patient by more oxygen gets in and more carbon dioxide flushes outside.To get better results with CPAP,some of the very important considerations are as fallow. 1.CPEP will only supply enough supply of oxygen,if the seal around the airways will tight enough.Ensure the tightening after installation of machine. 2.The air supplied from CPEP can cause dryness of the mouth and throat.A humidifier attachment is necessary. 3.Machine tubes and all parts should be well cleaned and free from any contamination.
how to treat obesity hypoventilation syndrome
In very severe case doctor can recommend tracheostomy in which an opening is made in trachea just below vocal cards and a tube is inserted in the opening for respiration.
Recommendations 1.Serum bicarbonate level of patient with obesity patient, that is suspected to have OHS,should be less than 27 mmol/litre 2. Ambulatory patient with OHS should receive positive airway pressure. 3. Continuous positive airway pressure should be preferred over non invasive ventilation 4. Patient hospitalized for breath failure and suspected to have OHS must be treated with noninvasive ventilation and after diagnosis with positive air pressure treatment.Further home ventilation and indoor air quality should be better. 5.In an article published by American thoracic society, weight loss is the best option to control various symptoms of obesity hypoventilation syndrome. Patient should be advised for weight loss upto 30 percent of his body weight ,more preferably by bariatric surgery.Physical activity is also recommended for weight loss.Smoking should be avoided, including passive smoking. see also 1.mental illness and obesity 2.dietary management for obesity
