CPAP or non-invasive ventilation in obesity hypoventilation syndrome: does it matter which one you start with?

In recent decades, the prevalence of obesity and severe obesity has increased significantly around the globe.1 2 As a consequence, it is likely that the prevalence of obesity-associated comorbidities such as obesity hypoventilation syndrome (OHS) will follow the same trend.3 OHS is the most severe form of respiratory compromise induced by obesity, leading to increased mortality and a wide array of comorbidities such as pulmonary hypertension, right heart failure and increased risk of hospitalisation due to acute-on-chronic hypercapnic respiratory failure.4–6 Unfortunately, OHS remains frequently unrecognised or misdiagnosed even in patients with severe obesity hospitalised with hypercapnic respiratory failure.7 8 Although positive airway pressure (PAP) remains the cornerstone therapy for OHS, controversy persists as to the preferred mode of PAP therapy for long-term management.9 In theory, non-invasive ventilation (NIV) should be more...

Source: Thorax - April 10, 2017 Category: Respiratory Medicine Authors: Noda, J. R., Masa, J. F., Mokhlesi, B. Tags: Editorials Source Type: research