Abstract
Background
Nocturnal noninvasive ventilation (NIV) is often a treatment option for obesity hypoventilation syndrome (OHS). Monitoring this treatment is important to verify its efficacy.
Aim
The aim of the present study was to assess the role of overnight pulse oximetry in the monitoring of OHS patients under NIV.
Patients and methods
Twenty patients with OHS using nocturnal bilevel positive airway pressure therapy without supplemental oxygen were included in the present study. Overnight pulse oximetry study was performed, and according to the results, the patients were divided into two groups: group I (normal study) and group II [abnormal study showing nocturnal percutaneous oxygen saturation (SpO2) <90% in ≥10% of the total recorded time]. Group II patients were subjected to respiratory polygraphy for more detailed assessment, and then, appropriate therapeutic modifications were done, after which a second overnight pulse oximetry study was performed to verify the efficacy of ventilation after these modifications.
Results
Twenty OHS patients using nocturnal NIV were included in the present study. There were eight (40%) male patients and 12 (60%) female patients, with a mean age of 58.7±7.39 years. The mean BMI was 45.86±3.71 kg/m2. Group I consisted of 11 (55%) patients and group II had nine (45%) patients. Respiratory polygraphy performed to group II detected airway obstruction in two patients, insufficient ventilation in five patients and significant nonintentional leaks in two patients. Therapeutic modifications were done, and then a second overnight pulse oximetry performed showing normal results in seven patients, whereas two patients showed lesser desaturations but results were still abnormal.
Conclusion
Overnight pulse oximetry is a very useful tool in assessment of NIV efficacy in OHS patients, it is portable, simple, and it can detect oxygen desaturations that direct to perform further tests to apply appropriate therapeutic modifications to optimize NIV.
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References
Skidmore PM, Yarnell JW. The obesity epidemic: prospects for prevention. Q J Med 2004; 97:817–825.
Olson AL, Zwillich C. The obesity hypoventilation syndrome. Am J Med 2005; 118:948–956.
Ahmed Q, Chung-Park M, Tomashefski JF Jr. Cardiopulmonary pathology in patients with sleep apnea/obesity hypoventilation syndrome. Hum Pathol 1997; 28:264–269.
Stepanski EJ. The need for a standardized CPAP titration protocol and follow-up procedures. J Clin Sleep Med 2005; 1:311.
Han F, Chen E, Wei H, He Q, Ding D, Strohl KP, et al. Treatment effects on carbon dioxide retention in patients with obstructive sleep apneahypopnea syndrome. Chest 2001; 119:1814–1819.
Kessler R, Chaouat A, Schinkewitch P, Faller M, Casel S, Krieger J, et al. The obesity-hypoventilation syndrome revisited: a prospective study of 34 consecutive cases. Chest 2001; 120:369–376.
Perez de Llano LA, Golpe R, Ortiz Piquer M, Veres Racamonde A, Vazquez Caruncho M, Caballero Muinelos O, et al. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesityhypoventilation syndrome. Chest 2005; 128:587–594.
Mokhlesi B, Tulaimat A, Evans AT, Wang Y, Itani AA, Hassaballa HA, et al. Impact of adherence with positive airway pressure therapy on hypercapnia in obstructive sleep apnea. J Clin Sleep Med 2006; 2:57–62.
Gonzalez C, Ferris G, Diaz J, Fontana I, Nunez J, Marin J. Kyphoscoliotic ventilatory insufficiency: effects of long-term intermittent positive-pressure ventilation. Chest 2003; 124:857–862.
Guo YF, Sforza E, Janssens JP. Respiratory patterns during sleep in obesity-hypoventilation patients treated with nocturnal pressure support: a preliminary report. Chest 2007; 131:1090–1099.
Janssens JP, Borel JC, Pépìn JL, SomnoNIV Group. Nocturnal monitoring of home non-invasive ventilation: the contribution of simple tools such as pulse oximetry, capnography, built-in ventilator software and autonomic markers of sleep fragmentation. Thorax 2011; 66:438–445.
Herer B, Roche N, Carton M, Roig C, Roujol V, Huchon G. Value of clinical, functional, and oximetric data for the prediction of obstructive sleep apnea in obese patients. Chest 1999; 116:1537–1544.
Epstein LJ, Dorlac GR. Cost-effectiveness analysis of nocturnal oximetry as a method of screening for sleep apnea hypopnea syndrome. Chest 1998; 113:97–103.
Rabec C, Georges M, Kabeya NK, Baudouin N, Massin F, Reybet-Degat O, et al. Evaluating noninvasive ventilation using a monitoring system coupled to a ventilator: a bench-to-bedside study. Eur Respir J 2009; 34:902–913.
Fanfulla F, Delmastro M, Berardinelli A, Lupo ND, Nava S. Effects of different ventilator settings on sleep and inspiratory effort in patients with neuromuscular disease. Am J Respir Crit Care Med 2005; 172:619–624.
Jounieaux V, Rodenstein DO. Home mechanical ventilation: indications and pathophysiological limitations. Rev Mal Respir 2004; 21:358–366.
Robert D, Argaud L. Non-invasive positive ventilation in the treatment of sleep-related breathing disorders. Sleep Med 2007; 8:441–452.
Gonzalez MM, Parreira VF, Rodenstein DO. Non-invasive ventilation and sleep. Sleep Med Rev 2002; 6:29–44.
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Shoukri, A. Study of the value of percutaneous nocturnal oximetry in the monitoring of obese hypoventilation syndrome patients under non invasive home ventilation. Egypt J Bronchol 11, 44–48 (2017). https://doi.org/10.4103/1687-8426.199005
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DOI: https://doi.org/10.4103/1687-8426.199005