Abstract
Obesity has become an increasingly concerning global epidemic, affecting millions of people across all age groups. It causes significant negative effects on the respiratory system, including profound changes to physiology of breathing, pulmonary mechanics and gas exchange, as well as increased work of breathing and dyspnea. A subset of obese patients develops obesity hypoventilation syndrome (OHS), which has substantial morbidity and mortality. This population of patients tends to have both hypoxemia and hypercapnia. There is good evidence to suggest that patients with OHS who have both acute and chronic hypercapnic respiratory failure would benefit from the use of bi-level positive airway pressure (BPAP). There is less evidence to support the use of BPAP in acute respiratory failure in the non OHS population but it is suggested that it is safe and can be beneficial in this group.
This is a preview of subscription content, log in via an institution to check access.
References
Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J. 2006;13(4):203–10.
Olson AL, Zwillich C. The obesity hypoventilations syndrome. Am J Med. 2005;118(9):948–56.
Bahammam AS, Al-Jawder SE. Managing acute respiratory decompensation in the morbidly obese. Respirology. 2012;17(5):759–71.
Carrillo A, Ferrer M, Gonzalez-Diaz G, et al. Noninvasive ventilation in acute hypercapnic respiratory failure caused by obesity hypoventilation syndrome and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186(12):1279–85.
Lemyze M, Taufour P, Duhamel A, et al. Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure. PLoS One. 2014;9(5):e97563.
Masa JF, Celli BR, Riesco JA, et al. The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation. Chest. 2001;119(4):1102–7.
Perez de Llano LA, Golpe R, Piquer MO, et al. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome. Chest. 2005;128(2):587–94.
Heinemann F, Budweiser S, Dobroschke J, et al. Non-invasive positive pressure ventilation improves lung volumes in obesity hypoventilation syndrome. Respir Med. 2007;101(6):1229–35.
Borel JC, Tamisier R, Gonzalez-Bermejo J, et al. Noninvasive ventilation in mild obesity hypoventilation syndrome: a randomized controlled trial. Chest. 2012;141(3):692–702.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Hilewitz, A.B., Miller, A.L., Mina, B. (2018). Obesity and Bi-level Positive Airway Pressure. In: Esquinas, A., Lemyze, M. (eds) Mechanical Ventilation in the Critically Ill Obese Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-49253-7_22
Download citation
DOI: https://doi.org/10.1007/978-3-319-49253-7_22
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-49252-0
Online ISBN: 978-3-319-49253-7
eBook Packages: MedicineMedicine (R0)