Non invasive ventilation for patients with obesity hypoventilation and acute hypercapnic respiratory failure

Abstract

Obstructive sleep-disordered breathing and obesity hypoventilation syndrome (OHS) are common pulmonary complications of obesity. Patients with OHS may present with acute-on-chronic exacerbation and acute hypercapnic respiratory failure (AHRF). Management of AHRF in obese patients is one of the most challenging problems facing respirologists, intensivists, and anesthesiologists in intensive care units. Noninvasive ventilation is the initial mainstay of treatment in patients with OHS who develop AHRF. The aims of treatment are to improve alveolar ventilation and alveolar gas exchange and to maintain a patent upper airway. In this chapter, we discuss the latest available information on the value of noninvasive ventilation in patients with OHS and AHRF.