Masa J F, Celli B R, Riesco J A, Hernández M, Sánchez De Cos J, Disdier C
Pulmonary Division, San Pedro de Alcántara Hospital, Cáceres, Spain.
Chest. 2001 Apr;119(4):1102-7. doi: 10.1378/chest.119.4.1102.
To assess the effectiveness of nasal noninvasive mechanical ventilation (NIMV) in patients with obesity hypoventilation syndrome (OHS).
Clinical assay that compares two groups of patients with hypercapnic respiratory failure, one group with OHS and the other group with kyphoscoliosis, in their basal situation and after 4 months of treatment with nocturnal NIMV. Thirty-six patients (22 patients with OHS and 14 patients with kyphoscoliosis) completed the study protocol.
The frequency of symptoms, such as morning headache, morning drowsiness, dyspnea, and leg edema, improved in a statistically significant way in both groups of patients. The sleepiness improved only in the group with OHS. The comparison of frequency of symptoms between both groups of patients after NIMV treatment did not present statistically significant differences. In the resting situation and without nasal ventilation in place, the PO(2) (mean +/- SD) changed from 51 +/- 10 to 64 +/- 11 mm Hg (p < 0.001) and PCO(2) from 58 +/- 10 to 45 +/- 5 mm Hg (p < 0.001) when the patients with OHS were treated with NIMV. In the group of patients with kyphoscoliosis, likewise without nasal ventilation in place, PO(2) changed from 53 +/- 6 to 65 +/- 5 mm Hg (p < 0.001) and PCO(2) from 59 +/- 11 to 45 +/- 4 mm Hg (p < 0.001) with NIMV treatment. When we compared PO(2) and PCO(2) in both groups of patients at the beginning and at the end of NIMV treatment, we did not find statistically significant differences between OHS and kyphoscoliosis.
NIMV improves the clinical symptoms and the respiratory failure of patients with OHS to a similar degree to that reported for diseases in which its use is completely established, such as kyphoscoliosis. Therefore, NIMV could be an alternative to the treatment of patients with OHS.
评估鼻无创机械通气（NIMV）对肥胖低通气综合征（OHS）患者的疗效。
一项临床分析，比较两组高碳酸血症性呼吸衰竭患者，一组为OHS患者，另一组为脊柱后凸侧弯患者，在基础状态及夜间NIMV治疗4个月后的情况。36例患者（22例OHS患者和14例脊柱后凸侧弯患者）完成了研究方案。
两组患者的症状频率，如晨起头痛、晨起嗜睡、呼吸困难和腿部水肿，均有统计学意义的改善。嗜睡仅在OHS组有所改善。NIMV治疗后两组患者症状频率的比较无统计学显著差异。在静息状态且未使用鼻通气时，OHS患者接受NIMV治疗时，动脉血氧分压（PO₂）（均值±标准差）从51±10 mmHg变为64±11 mmHg（p<0.001），动脉血二氧化碳分压（PCO₂）从58±10 mmHg变为45±5 mmHg（p<0.001）。在脊柱后凸侧弯患者组，同样未使用鼻通气时，PO₂从53±6 mmHg变为65±5 mmHg（p<0.001），PCO₂从59±11 mmHg变为45±4 mmHg（p<0.001）。当比较两组患者在NIMV治疗开始和结束时的PO₂和PCO₂时，我们未发现OHS组和脊柱后凸侧弯组之间存在统计学显著差异。
NIMV改善OHS患者的临床症状和呼吸衰竭的程度，与已完全确立其使用的疾病（如脊柱后凸侧弯）所报道的程度相似。因此，NIMV可能是OHS患者治疗的一种替代方法。
