OVERVIEW
OVERVIEW
Obesity hypoventilation syndrome is a condition in which an obese patient is accompanied by chronic hypercapnia when calmly breathing room air in the waking state, ultimately leading to Pickwickian syndromne (Pickwick’s syndrome) The main symptoms are hypercapnia, hypoxia, erythrocytosis, pulmonary hypertension, and total heart failure.
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Department of Medicine
Respiratory Medicine
Clinical Symptoms
Obesity, dyspnea, irritability, sleep disturbances, cyanosis, and malaise.
Hazards
Multiple complications can occur, even respiratory failure and sudden death.
Complications
Pulmonary hypertension, pulmonary heart disease, right heart failure, respiratory failure, etc.
Examination
Physical examination, blood routine, blood gas analysis, sleep monitoring, etc.
Diagnosis
Diagnosis is made on the basis of obesity, dyspnea and blood gas analysis, sleep monitoring.
Treatment principle
Continuous positive-pressure ventilation and weight control.
Curability
Aggressive treatment may improve symptoms.
Dietary recommendations
Low-fat diet, regular and frequent meals, abstain from smoking and alcohol.
Etiology
Etiology
The cause of the disease is not clear.
Symptoms and Diagnosis
Typical symptoms
In the early stage, there may be only the manifestation of obesity. With the development of the disease, irritability, shallow and rapid breathing, easy fatigue and dyspnea after activity gradually appear, etc. In the aggravation of the disease, there are symptoms related to sleep deprivation such as dyspnea and sleep disorders at rest, daytime sleepiness, sleepiness, fatigue, and impaired responsiveness, memory, and alertness. In patients with severe hypoventilation, cyanosis, severe drowsiness, and apathetic response are present, and respiration is characterized by periodic hypoventilation and apnea, which is more pronounced during sleep.
Diagnostic basis
1. Symptoms are mostly manifested by obesity, and with the progression of the disease, the symptoms of dyspnea are aggravated, and there may be irritability, sleep disorder, cyanosis, fatigue, and indifference.2. Auxiliary examination of the blood routine shows an increase in the red blood cell count, and an increase in the hematocrit and hemoglobin content; the blood gas analysis reveals that the arterial partial pressure of oxygen is lowered, and the arterial partial pressure of carbon dioxide is lowered; and the sleep monitoring reveals that oxygen saturation is decreased during sleep.
Treatment
Treatment guidelines
Continuous positive pressure ventilation is preferred, along with aggressive weight control.
Other treatments
1. Continuous positive pressure ventilation is the first choice for the treatment of this disease, including nasal continuous positive pressure ventilation and bi-level positive pressure ventilation, etc. 2. Weight control by controlling diet and enhancing exercise is an important adjunctive treatment.
Prognosis
Aggressive treatment can improve the prognosis.
Nursing care
Daily care
1.EnvironmentProvide patients with a quiet and comfortable environment, keep indoor air fresh and clean, pay attention to ventilation, and maintain appropriate temperature and humidity.2.Rest and exerciseLive a regular life and combine work and rest. If the condition permits, maintain a certain amount of activity in a planned manner, and encourage patients to try some appropriate aerobic exercise, which can help control weight.3. Psychological careConsoling patients, giving psychological support to enhance their sense of security, so that they can maintain emotional stability.
Dietary management
Low-fat diet, regular and quantitative meals, quit smoking and alcohol.