Short-term effects, long-term compliance and admissions in patients with obesity hypoventilation syndrome under noninvasive mechanical ventilation

Abstract

Background: Noninvasive ventilation (NIV) is an established treatment for patients with obesity hypoventilations syndrome (OHS), however short-term physiologic effects, compliance data and admissions remains lacking. Objective: To describe and analyze the short-term physiologic effects of a NIV ambulatory adaptation, a compliance follow-up and admissions, in stable patients with OHS. Methods: One hundred and twenty nine patients (91 females), with median(IQR) age of 68(59-77), BMI of 40(36-44), AHI of 35(19-64) witch 54%>30, and PaCO2 of 50(47-53)were submitted to NIV ambulatory adaptation. Ventilator settings were titrated gradually for the patient comfort with IPAP of 21(18-24), EPAP of 9(8-11), Respiratory Rate (RR) of 14(14-15) and in 120 patients (93%) with a oro-nasal interface. Pulse oximetry (SpO2), transcutaneous CO2 (TcCO2), RR, Tidal Volume (Vt) were registered before and after the NIV trial. A 6 months compliance follow-up was performed. Results: All patients had a significant improvement in RR [22(20-24) vs 15(15-17) bpm, p Conclusions: This study confirms that NIV ambulatory adaptation improves short-term physiologic parameters, the long-term compliance and low rate of respiratory admissions in OHS patients.