متلازمة نقص التهوية السمنية مع السمنة (مؤشر كتلة الجسم ≥30) وانقطاع التنفس الانسدادي الشديد — عندما لا يحقق الجهاز التنفسي غير الغازي أهداف ثاني أكسيد الكربون النهاري

References

1. Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥30 kg·m⁻²), daytime hypercapnia (arterial carbon dioxide tension ≥45 mmHg) and sleep disordered breathing, after ruling out other disorders that may cause alveolar hypoventilation. DOI: 10.1183/16000617.0097-2018
2. Nearly 70% of patients have concomitant severe OSA (AHI ≥30 events·h⁻¹). DOI: 10.1183/16000617.0097-2018
3. CPAP is considered the first-line treatment modality for OHS phenotype with concomitant severe obstructive sleep apnoea, whereas NIV is preferred in the minority of OHS patients with hypoventilation during sleep with no or milder forms of obstructive sleep apnoea (approximately <30% of OHS patients). DOI: 10.1183/16000617.0097-2018
4. There are case report data and a small RCT assessing the role of respiratory stimulants, such as medroxyprogesterone and acetazolamide, which augment ventilation in patients with OHS and can be considered in patients intolerant of PAP. DOI: 10.1183/16000617.0097-2018