Onofri Angelo, Patout Maxime, Kaltsakas Georgios, Lhuillier Elodie, Mushemi-Blake Sitali, Arbane Gill, Pengo Martino F, Marino Philip, Steier Joerg
Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Medicine (DIMED), University of Padua, Padua, Italy.
J Thorac Dis. 2018 Jan;10(Suppl 1):S135-S143. doi: 10.21037/jtd.2017.12.129.
Chronic hypercapnic respiratory failure (HRF) in obesity hypoventilation syndrome (OHS) is commonly treated using non-invasive ventilation (NIV). We hypothesised that treatment of OHS would improve neural respiratory drive index (NRDI) and cardiac function.
Fourteen patients (8 females) with OHS, who were admitted for initiation of domiciliary NIV, were prospectively studied. Patients had (mean ± SD): age (53±10 years), body mass index (BMI) (50.1±10.8 kg/m), and pCO (7.3±0.9 kPa). NRDI was assessed by surface electromyogram of the parasternal intercostals. Cardiac function was assessed by transthoracic echocardiography (TTE). All measurements were performed at baseline, 6 weeks, and 3 months.
NRDI improved on day one following NIV set-up comparing to baseline (484.2±214.8 316.5±106.5 AU) and this improvement was maintained at 6 weeks (369.1±173.2 AU) and at 3 months (351.2±167.1 AU) (P=0.004). No significant differences were identified in terms of cardiac function between baseline and 3 months [tricuspid annular plane systolic excursion (TAPSE) (24.6±5.8 23.0±4.0 mm, P=0.317); systolic pulmonary artery (PA) pressures (36.7±15.2 44.5±23.9 mmHg, P=0.163].
NIV improves NRDI in patients with OHS, while the cardiac function over a three-month period remains unchanged.
肥胖低通气综合征（OHS）中的慢性高碳酸血症呼吸衰竭（HRF）通常采用无创通气（NIV）进行治疗。我们假设OHS的治疗会改善神经呼吸驱动指数（NRDI）和心脏功能。
对14例因开始家庭NIV治疗而入院的OHS患者（8例女性）进行前瞻性研究。患者的（均值±标准差）：年龄（53±10岁），体重指数（BMI）（50.1±10.8kg/m²），以及动脉血二氧化碳分压（pCO₂）（7.3±0.9kPa）。通过胸骨旁肋间肌的表面肌电图评估NRDI。通过经胸超声心动图（TTE）评估心脏功能。所有测量均在基线、6周和3个月时进行。
与基线相比，NIV设置后第1天NRDI有所改善（484.2±214.8对316.5±106.5AU），并且这种改善在6周时（369.1±173.2AU）和3个月时（351.2±167.1AU）得以维持（P=0.004）。在基线和3个月之间，心脏功能方面未发现显著差异[三尖瓣环平面收缩期位移（TAPSE）（24.6±5.8对23.0±4.0mm，P=0.317）；收缩期肺动脉（PA）压力（36.7±15.2对44.5±23.9mmHg，P=0.163）]。
NIV可改善OHS患者的NRDI，而在三个月期间心脏功能保持不变。
