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Editorials |

Obesity-Hypoventilation Syndrome and Noninvasive Mechanical Ventilation: New Insights in the Pickwick Papers?

Antoine Cuvelier, MD; Jean-François Muir, MD
Author and Funding Information

Affiliations: Rouen, France ,  Dr. Cuvelier is Assistant Professor, and Dr. Muir is Professor and Chairman of the Pulmonary and Intensive Care Department, Rouen University Hospital.

Correspondence to: Antoine Cuvelier, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bois-Guillaume, CHU de Rouen 76031 Rouen Cedex, France; e-mail: antoine.cuvelier@chu-rouen.fr


Chest. 2007;131(1):7-8. doi:10.1378/chest.06-2540
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Extract

Obesity is of growing concern all over the world since > 312 millions of individuals have a body mass index > 30 kg/m2. Respiratory consequences of obesity are now of major concern in the pulmonary specialty, including asthma, obstructive sleep apnea syndrome (OSAS), obesity-hypoventilation syndrome (OHS), and some acute situations like hypercapnic respiratory failure and respiratory postsurgical complications. OHS is commonly defined as the association of obesity with daytime hypercapnia (Paco2 > 45 mm Hg) in the absence of any other respiratory disease. OHS is one of the many etiologies of chronic respiratory failure and has become a frequent indication to initiate long-term noninvasive mechanical ventilation (NIV) in most European countries.1 Nocturnal NIV has been shown to be clinically effective in OHS because of a rapid and sustained improvement of daytime arterial blood gas levels2 and a net reduction of daytime sleepiness. However, mechanisms of improvement under NIV remain unclear, as well as the physiopathology and the natural history of the disease.


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