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Adipositasassoziierte Atmungsstörungen –„State of the Art“

Obesity-related breathing disorders: “State of the Art”

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Zusammenfassung

Die adipositasassoziierten Atmungsstörungen umfassen die obstruktive Schlafapnoe, die schlafbezogene alveoläre Hypoventilation und das Vollbild des Obesitas-Hypoventilationssyndroms. Die Pathophysiologie fußt auf adipositasbedingten Veränderungen des respiratorischen Systems mit Einengung des oberen Atemwegsdiameters, verringerter thorakaler Compliance, erhöhtem intrinsischen positiven endexspiratorischen Druck, vermehrtem Ventilations-Perfusions-Mismatch und verringerter Kohlendioxidsensitivität. Es besteht eine enge Korrelation zu metabolischen und kardiovaskulären Erkrankungen wie der Herzinsuffizienz, der koronaren Herzkrankheit und der pulmonalen Hypertonie. Je nach pathophysiologischem Schwerpunkt sind therapeutisch kontinuierliche oder Bilevel-Positivdrucktherapieverfahren etabliert.

Abstract

Obesity-related breathing disorders include obstructive sleep apnea, sleep-related alveolar hypoventilation, and full-blown obesity hypoventilation syndrome. The pathophysiology is based on obesity-related changes of the respiratory system, with upper-airway collapsibility, reduced thoracic compliance, increased intrinsic positive end-expiratory pressure, increased ventilation-perfusion mismatch, and reduced carbon dioxide sensitivity. There is a close correlation with metabolic and cardiovascular diseases such as heart failure, coronary heart disease, and pulmonary hypertension. Depending on the pathophysiological accentuation, continuous and bilevel positive pressure are established therapy methods.

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  1. Klinik für Pneumologie und Allergologie, Zentrum für Schlaf- und Beatmungsmedizin, Krankenhaus Bethanien, Aufderhöher Str. 169–175, 42699, Solingen, Deutschland

    Simon Herkenrath & Winfried Randerath

  2. Institut für Pneumologie an der Universität zu Köln, Krankenhaus Bethanien gGmbH, Aufderhöher Str. 169–175, 42699, Solingen, Deutschland

    Simon Herkenrath

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Herkenrath, S., Randerath, W. Adipositasassoziierte Atmungsstörungen –„State of the Art“. Somnologie 24, 168–175 (2020). https://doi.org/10.1007/s11818-020-00258-5

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