Saka Dian Dina Sholihah, Novida Hermina
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Ann Med Surg (Lond). 2023 Apr 11;85(5):2169-2172. doi: 10.1097/MS9.0000000000000665. eCollection 2023 May.
Obesity hypoventilation syndrome (OHS) is an often overlooked and limited case with other conditions that can cause hypoventilation.
An Indonesian female, 22 years old, always feels sleepy, has difficulty concentrating and controlling her appetite. The patient had a fever, respiratory rate of 32 ×/min, pulse rate of 115 ×/min, apathy, obesity (BMI =46.6 kg/m), and she used oxygen therapy with a non-rebreathing mask of 10 l/min (SO of 89%). The patients had daytime hypercapnia & alveolar hypoventilation without other causes of hypoventilation. She was likely to have a chronic condition with relatively stable symptoms that had fallen into a state of acute on chronic hypercapnic respiratory failure. The patient used mechanical ventilation and received supportive management. After 19 days of treatment, the patient's condition improved, and it was recommended to lose weight gradually. In 1-week post hospitalization, the patient experienced a weight loss of 5 kg.
Mechanical ventilation, supportive management, and decreased body weight of 25-30% gradually have improved prognosis in OHS patients. Bariatric surgery is carried out when the patient cannot lose weight with diet and exercise.
OHS management includes oxygen therapy and gradually decreased body weight.
肥胖低通气综合征（OHS）是一种常被忽视且与其他可导致低通气的病症相关的有限病例。
一名22岁的印度尼西亚女性，总是感到困倦，难以集中注意力并控制食欲。患者发热，呼吸频率为32次/分钟，脉搏率为115次/分钟，神情淡漠，肥胖（体重指数=46.6kg/m²），她使用10升/分钟的无重复呼吸面罩进行氧疗（血氧饱和度为89%）。患者存在白天高碳酸血症和肺泡低通气，且无其他导致低通气的原因。她可能患有症状相对稳定的慢性病，已陷入慢性高碳酸血症呼吸衰竭急性发作状态。患者接受了机械通气并接受了支持性治疗。经过19天的治疗，患者病情好转，建议逐渐减重。住院1周后，患者体重减轻了5千克。
机械通气、支持性治疗以及逐渐减轻25 - 30%的体重可改善OHS患者的预后。当患者通过饮食和运动无法减重时，可进行减重手术。
OHS的治疗包括氧疗和逐渐减重。
