Obesity-hypoventilation syndrome: state-of-the-art

Abstract

Obesity-hypoventilation syndrome (OHS) is a combination of obesity and hypercapnic chronic respiratory failure, without any other causes of hypercapnia. OHS is frequently associated with obstructive sleep apnea hypopnea syndrome (80%). Its prevalence is increasing in relation to the epidemics of obesity in Occidental countries. Clinical presentation including dyspnea and fatigue is not specific and may explain that OHS is under-recognized, responsible for many recurrent admissions in the intensive care unit for acute hypercapnic respiratory failure, generally associated with clinical right ventricular failure.Without any treatment, patients with OHS have a lower quality of life with increased healthcare expenses by recurrent hospitalisations and are at a higher risk for the development of pulmonary hypertension, metabolic and vascular morbidities as well as early mortality, in comparison to eucapnic obese patients. Available treatments include home continuous or bi-level positive airway pressure therapy, well-tolerated and effective to reduce mortality as well as different approaches for weight loss including bariatric surgery.