NIV and chronic respiratory failure secondary to obesity

Jp, Janssens; Pépin, J.L.; Guo, Yan

doi:10.1183/1025448x.00041017

Cited by 3 publications

(3 citation statements)

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“…Moreover, residual respiratory events occur frequently in OHS patients treated with nocturnal NIV. Additional attention is required to ensure treatment efficacy and avoid machine‐related undesirable respiratory events 88,89 . Thus, in the absence of long‐term randomized trials comparing NIV with CPAP in patients with predominant OSA‐related hypoventilation, 85 NIV should be reserved for OHS patients presenting with primarily central hypoventilation during sleep.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

“…Additional attention is required to ensure treatment efficacy and avoid machine-related undesirable respiratory events. 88,89 Thus, in the absence of long-term randomized trials comparing NIV with CPAP in patients with predominant OSA-related hypoventilation, 85 NIV should be reserved for OHS patients presenting with primarily central hypoventilation during sleep. Manufacturers have proposed new ventilatory modes (example: average volume-assured pressure support, volume targeting by bi-level positive pressure ventilation 90,91 and auto-titrating NIV 92 ), but the efficacy of these modes needs to be assessed in larger cohort studies and on a long-term follow-up basis.…”

Section: Positive Airway Pressure Therapies To Abolish Sleep-breathinmentioning

confidence: 99%

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Obesity hypoventilation syndrome: From sleep‐disordered breathing to systemic comorbidities and the need to offer combined treatment strategies

Borel

Monneret

et al. 2012

Respirology

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Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index Ն 30 kg/m2 ), daytime hypercapnia (partial arterial carbon dioxide concentration Ն45 mm Hg) and sleepdisordered breathing after ruling out other disorders that may cause alveolar hypoventilation. Through the prism of the International Classification of Functioning, OHS is a chronic condition associated with respiratory, metabolic, hormonal and cardiovascular impairments, leading to a decrease in daily life activities, a lack of social participation and high risk of hospitalization and death. Despite its severity, OHS is largely underdiagnosed and the health-related costs are higher than those of apnoeic or obese eucapnic patients. The present review discusses the definition, epidemiology, physiopathology and treatment modalities of OHS. Although nocturnal positive airway pressure therapies represent first-line treatment and are effective in improving patient outcomes, there is a need to offer combined treatment strategies and to assess the effect of multimodal therapeutic strategies on morbidity and mortality.The Authors: Jean-Christian Borel, PhD, is the Head of the Research and Development Department at 'AGIR à dom', a non-profit home care provider. He has developed an expertise in the field of non-invasive ventilation, home-based training programmes and integrated care. He carried out his PhD thesis at the Hypoxia Pathophysiology Laboratory (HP2) on the clinical and cardiovascular consequences of the obesity hypoventilation syndrome, followed by a postdoctoral fellowship on the pathophysiology of the sleep apnoea syndrome in Dr Frederic Series' team at the Quebec Heart and Lung Institute.Anne-Laure Borel, MD, PhD from Grenoble University Hospital, France, has completed a postdoctoral fellowship in Quebec, Canada in Dr Jean-Pierre Despres' team of the Quebec Heart and Lung Institute. She is an endocrinologist with a clinical activity focused on obesity and type 2 diabetes. Her research interests are in the field of the cardiometabolic complications of an excess visceral adiposity and more specifically, the association between sleep-disordered breathing, excess visceral fat and metabolic abnormalities.Denis Monneret, MSc, PhD, is a pharmacist with a diploma of medical biology from Lille Faculty of Pharmacy, France. His MSc and PhD degrees specialized in biology of obstructive sleep apnoea and obesity hypoventilation syndrome. After working as Assistant Professor in the Biochemistry and Hormonology Unit at Grenoble University Hospital, he joined the HP2 Laboratory where he works on oxidative stress and metabolic biomarkers of obstructive sleep apnoea, and obesity hypoventilation syndrome.Renaud Tamisier, MD, PhD, is an Associate Professor of Physiology at Grenoble University School of Medicine, France. He works in the HP2 Laboratory and has been involved in both research and clinical studies in sleep-disordered breathing for the last 15 years. His research interests are mainly on the cardiovascular consequence...

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Section: Treatment Modalitiesmentioning

confidence: 99%

Section: Positive Airway Pressure Therapies To Abolish Sleep-breathinmentioning

confidence: 99%

Obesity hypoventilation syndrome: From sleep‐disordered breathing to systemic comorbidities and the need to offer combined treatment strategies

Borel

Monneret

et al. 2012

Respirology

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“…CPAP and NIV are the primary treatment options for OHS patients with CRF [62], in accordance with the following.…”

Section: Methodsmentioning

confidence: 99%

Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

Windisch¹,

Walterspacher²,

Siemon³

et al. 2010

Pneumologie

140

108

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S2k-Leitlinie: Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz – Revision 2017

et al. 2017

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Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published. Thereby, the existing chapters, namely technical issues, organizational structures in Germany, qualification criteria, disease specific recommendations including special features in pediatrics as well as ethical aspects and palliative care, have been updated according to the current literature and the health care developments in Germany. New chapters added to the guidelines include the topics of home mechanical ventilation in paraplegic patients and in those with failure of prolonged weaning.In the current guidelines different societies as well as professional and expert associations have been involved when compared to the 2010 guidelines. Importantly, disease-specific aspects are now covered by the German Interdisciplinary Society of Home Mechanical Ventilation (DIGAB). In addition, societies and associations directly involved in the care of patients receiving home mechanical ventilation have been included in the current process. Importantly, associations responsible for decisions on costs in the health care system and patient organizations have now been involved.The currently updated guidelines are valid for the next three years, following their first online publication on the home page of the Association of the Scientific Medical Societies in German (AWMF) in the beginning of July 2017. A subsequent revision of the guidelines remains the aim for the future.

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NIV and chronic respiratory failure secondary to obesity

Cited by 3 publications

References 0 publications

Obesity hypoventilation syndrome: From sleep‐disordered breathing to systemic comorbidities and the need to offer combined treatment strategies

Obesity hypoventilation syndrome: From sleep‐disordered breathing to systemic comorbidities and the need to offer combined treatment strategies

Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

S2k-Leitlinie: Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz – Revision 2017

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