REVIEW  XIII PNEUMOLAB PROCEEDINGS Free access

Minerva Medica 2018 December;109(6 Suppl 1):1-5

DOI: 10.23736/S0026-4806.18.05921-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Non-invasive ventilation in acute respiratory failure of patients with obesity hypoventilation syndrome

Antonello NICOLINI ¹ ✉, Matteo FERRANDO ², Paolo SOLIDORO ³, Fabiano DI MARCO ⁴, Fabrizio FACCHINI ⁵, Fulvio BRAIDO ²

¹ Unit of Respiratory Diseases, Hospital of Sestri Levante, Sestri Levante, Italy; ² Unit of Respiratory Diseases and Allergies, Department of Internal Medicine (DiMI), San Martino University Hospital, Genoa, Italy; ³ Unit of Pneumology, Department of Cardiovascular and Thoracic Surgery, Molinette University Hospital, Città della Salute e della Scienza, Turin, Italy; ⁴ Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy; ⁵ Department of Pulmonary Medicine, Valiant Clinic, Meraas HealthCare, Dubai, United Arab Emirates

INTRODUCTION: Non-invasive ventilation (NIV) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades compared to prior decades. There are particular groups of patients that are more likely to benefit from NIV. One of these groups is patients with obesity hypoventilation syndrome (OHS). The aim of this review is to evalue the effectiveness of NIV in acute ARF.
EVIDENCE ACQUISITION: MEDLINE, EMBASE, CINHAIL, Cochrane Central Register of Controlled Trials, DARE, the Cochrane Database of Systematic Reviews, and the ACP Journal Club database were searched from January 2001 to December 2017.
EVIDENCE SYNTHESIS: More than 30% of them have been diagnosed when hospitalized for ARF. NIV rarely failed in reversing ARF. OHS patients who exhibited early NIV failure had a high severity score and a low HCO3 level at admission; more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV.
CONCLUSIONS: Patients with decompensation of OHS have a better prognosis and response to NIV than other hypercapnic patients. They required more aggressive NIV settings, a longer time to reduce paCO2 levels, and showed more frequently a delayed but successful response to NIV.

KEY WORDS: Cardiovascular abnormalities - Continuous positive airway pressure - Noninvasive ventilation - Sleep apnea syndromes