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Editorials |

The Obesity-Hypoventilation Syndrome Revisited

Harry Teichtahl, MBBS (Hons), FCCP
Author and Funding Information

Affiliations: Melbourne, Australia 
 ,  Dr. Teichtahl is Director, Department of Respiratory and Sleep Disorders Medicine, Western Hospital.

Correspondence to: Harry Teichtahl, MBBS, FCCP, Western Hospital, Gordon St, Footscray, Victoria, Australia 3011; e-mail: Harry.Teichtahl@wh.org.au



Chest. 2001;120(2):336-339. doi:10.1378/chest.120.2.336
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The obesity-hypoventilation syndrome (OHS) was originally described in 1955 in subjects with obesity, chronic daytime hypercapnia and hypoxemia, polycythemia, hypersomnolence, and right ventricular failure.1 In 1956, Burwell et al2 coined the term pickwickian syndrome for these patients because they resemble the messenger boy Joe in Charles Dickens’ The Pickwick Papers. OHS is one of the many disease states associated with chronic hypercapnia and alveolar hypoventilation. Lung, neuromuscular, chest wall, and metabolic diseases need to be excluded prior to making a diagnosis of OHS.3 The daytime hypoxemia and raised alveolar-arterial oxygen gradient found in patients with OHS suggest that ventilation-perfusion inequality as well as alveolar hypoventilation is important in this condition.4 With increasing knowledge of the effects of obesity and sleep on respiration, ventilatory control during sleep, and sleep-disordered breathing syndromes, we should be able to further explore the pathogenesis of OHS. Early recognition of OHS patients is important because management options for them have increased substantially in the last few years.

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