Clinical condition of patients with Obesity Hypoventilation Syndrome (OHS): case report
Abstract
Abstract. Obesity hypoventilation syndrome (OHS) or Pickwikian's syndrome consists of obesity, breathing-related sleep disturbances, and chronic daytime hypoventilation. Identifying OHS is essential due to the risk of clinical exacerbation leading to respiratory failure and the high mortality rate among untreated patients. A 55-year-old woman was admitted to the emergency room with two days of weakness and fatigue. She is unable to perform daily tasks due to shortness of breath. She was recently diagnosed with diabetes. The patient weighs 133 kilograms and has a height of 155 centimeters (Body Mass Index of 55,4 kg/m2). The patient's blood glucose was 351 mg/dl, with an abnormal result of HbA1C of 11.5%. The blood pressure tends to stage 1 hypertension, and arterial blood gas examination showed respiratory acidosis. We diagnosed her with obesity hypoventilation syndrome, type 2 diabetes, and stage 1 hypertension. During her five-day hospitalization, her condition improved. Correct diagnosis and management can improve the patient's quality of life and decrease the risk of comorbidities. In addition, it can reduce the cost and time of hospital care.
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References
- S. Jonathan and M. Rasmin, “Multiple Possible Causes of Dyspnea in an Unusual Pickwickian Syndrome on Covid-19 Pandemic: A Case Study,” Respir. Sci., vol. 2, no. 2, pp. 92–109, 2022, doi: 10.36497/respirsci.v2i2.44.
- Tham KW, Abdul Ghani R, Cua SC, et al. Obesity in South and Southeast Asia-A new consensus on care and management. Obes Rev. 2023;24(2):e13520. doi:10.1111/obr.13520
- D. Takaryanto, A. Erna, and H. Suryadinata, “Pulmonary Hypertension in Obesity Hypoventilation Syndrome: A Case Report,” Indones. J. Chest Crit. Emerg. Med., vol. 4, no. 4, pp. 37–45, 2017.
- M. Mukhlis and A. Bakhtiar, “Obstructive Sleep Apnea (OSA), Obesitas Hypoventilation Syndrome (OHS) dan Gagal Napas,” J. Respirasi, vol. 1, no. 3, pp. 94–102, 2015, doi: 10.20473/jr.v1-I.3.2015.94-102.
- Brown LK., Obesity Hypoventilation Syndrome, Curr Sleep Medicine Rep, 2015, 1:241–250. DOI: 10.1007/s40675-015-0026-8
- Athayde, RAB, J. Filho, G. Filho, and P. Genta, “Obesity hypoventilation syndrome: a current review,” J. Bras. Pneumol., vol. 44, no. 6, pp. 510–518, 2018, doi: 10.1590/S1806-37562017000000332.
- N. Putri, D. Utami, I. Budiarsa, and S. Trisnawati, “Sindrom Pickwickian-Sindrom Hipoventilasi pada Obesitas: Laporan Kasus dengan Pendekatan Diagnosis Klinis,” Neurona Maj. Kedokt. Neurosains, vol. 36, no. 2, pp. 120–123, 2019, doi: doi.org/10.52386/neurona.v36i2.64.
- Iftikhar, MDa,*, Joshua Roland, MDb,c , Obesity Hypoventilation Syndrome. Clin Chest Med 39 (2018) 427–436. https://doi.org/10.1016/j.ccm.2018.01.006
- Jay S. Balachandran, MDa,*, Juan Fernando Masa, MD, PhDb,c, and Babak Mokhlesi, MD, MSca. Obesity Hypoventilation Syndrome Epidemiology and Diagnosis. Sleep Med Clin . 2014 September ; 9(3): 341–347. doi:10.1016/j.jsmc.2014.05.007
- J. Masa, J. Pépin, J. Borel, B. Mokhlesi, P. Murphy, and M. Sánchez-Quiroga, “Obesity hypoventilation syndrome,” Eur. Respir. Rev., vol. 28, no. 180097, pp. 1–14, 2019, doi: 10.1183/16000617.0097-2018.
- P2PTM Kemenkes RI, “Klasifikasi Obesitas Setelah Pengukuran IMT,” 2018. www.p2ptm.kemkes.go.id/infographic-p2ptm/obesitas/klasifikasi-obesitas-setelah-pengukuran-imt (accessed Dec. 22, 2022).
- C. Liu, M. Chen, and H. Yu, “The relationship between obstructive sleep apnea and obesity hypoventilation syndrome: a systematic review and meta-analysis,” Oncotarget, vol. 8, no. 54, pp. 93168–93178, 2017, doi: 10.18632/oncotarget.21450.
- Shetty S, Parthasarathy S. Obesity Hypoventilation Syndrome. Curr Pulmonol Rep. 2015;4(1):42-55. doi:10.1007/s13665-015-0108-6
- D. Sajkov, B. Mupunga, J. J. Bowden, C. Langton, and N. Petrovsky, “Narrative Review: Obesity, Type 2 DM and Obstructive Sleep Apnoea—Common Bedfellows,” Diabetology, vol. 3, no. 3. pp. 447–459, 2022, doi: 10.3390/diabetology3030033.
- Ryan S. Adipose tissue inflammation by intermittent hypoxia: mechanistic link between obstructive sleep apnoea and metabolic dysfunction. J Physiol. 2017;595(8):2423-2430. doi:10.1113/JP273312
- O. K. Basoglu and M. S. Tasbakan, “Comparison of clinical characteristics in patients with obesity hypoventilation syndrome and obese obstructive sleep apnea syndrome: a case-control study,” Clin. Respir. J., vol. 8, no. 2, pp. 167–174, Apr. 2014, doi: https://doi.org/10.1111/crj.12054.
- M. V. M., S. K. J., L. Janine, and M. H. K., “Diagnostic Predictors of Obesity-Hypoventilation Syndrome in Patients Suspected of Having Sleep Disordered Breathing,” J. Clin. Sleep Med., vol. 09, no. 09, pp. 879–884, Jan. 2023, doi: 10.5664/jcsm.2986.
- C. C. Lacalzada and S. Díaz-Lobato, “Grading obesity hypoventilation syndrome severity,” Eur. Respir. J., vol. 32, no. 3, pp. 817 LP – 818, Sep. 2008, doi: 10.1183/09031936.00059508.
- Z. Zahtamal, Y. Prabandari, and L. Setyawati, “Prevalensi Sindrom Metabolik pada Pekerja Perusahaan,” Kesmas J. Kesehat. Masy. Nas., vol. 9, no. 2, pp. 113–120, 2014, doi: 10.21109/kesmas.v9i2.499.
- Tahapary DL, Harbuwono DS, Yunir E, Soewondo P. Diagnosing metabolic syndrome in a multi-ethnic country: is an ethnic-specific cut-off point of waist circumference needed?. Nutr Diabetes. 2020;10(1):19. Published 2020 Jun 8. doi:10.1038/s41387-020-0123-8
- M. Schetz et al., “Obesity in the critically ill: a narrative review,” Intensive Care Med., vol. 45, no. 6, pp. 757–769, 2019, doi: 10.1007/s00134-019-05594-1.
- M. Pattipati, G. Gudavalli, and L. Dhulipalla, “The Influence of Obesity Hypoventilation Syndrome on the Outcomes of Patients With Diabetic Ketoacidosis,” Cureus, vol. 14, no. 5, p. e25157, 2022, doi: 10.7759/cureus.25157.
- P. K. Whelton et al., “2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines,” Hypertension, vol. 71, no. 6, pp. e13–e115, Jun. 2018, doi: 10.1161/HYP.0000000000000065.
- M. Alawami, A. Mustafa, K. Whyte, M. Alkhater, Z. Bhikoo, and J. Pemberton, “Echocardiographic and electrocardiographic findings in patients with obesity hypoventilation syndrome,” Intern. Med. J., vol. 45, no. 1, pp. 68–73, Jan. 2015, doi: https://doi.org/10.1111/imj.12620.
- W. Chavey, “The importance of beta blockers in the treatment of heart failure,” Am. Fam. Physician, vol. 62, no. 11, pp. 2453–62, 2000.
- D. Masarone, M. L. Martucci, V. Errigo, and G. Pacileo, “The Use of ?-Blockers in Heart Failure with Reduced Ejection Fraction,” Journal of Cardiovascular Development and Disease, vol. 8, no. 9. 2021, doi: 10.3390/jcdd8090101.
- Cignarelli et al., “Postprandial glucose and HbA1c are associated with severity of obstructive sleep apnoea in non-diabetic obese subjects,” J. Endocrinol. Invest., vol. 44, no. 12, pp. 2741–2748, 2021, doi: 10.1007/s40618-021-01602-8.
- K. Tran et al., “Elucidating Predictors of Obesity Hypoventilation Syndrome in a Large Bariatric Surgery Cohort,” Ann. Am. Thorac. Soc., vol. 17, no. 10, pp. 1279–1288, Jun. 2020, doi: 10.1513/AnnalsATS.202002-135OC.
- Perkeni, Pedoman Petunjuk Praktis Terapi Insulin pada Pasien Diabetes Melitus. Jakarta: PB Perkeni, 2021.
- Davidson MB. Insulin Therapy: A Personal Approach. Clin Diabetes. 2015;33(3):123-135. doi:10.2337/diaclin.33.3.123
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