Document Detail


Long-term outcome of noninvasive positive pressure ventilation for obesity hypoventilation syndrome.
MedLine Citation:
PMID:  20348200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few data are available on the long-term outcome of noninvasive positive pressure ventilation (NPPV) for obesity hypoventilation syndrome (OHS). This study was designed to determine long-term survival, treatment adherence, and prognostic factors in patients with OHS in whom NPPV was initiated in an acute setting vs under stable clinical conditions.
METHODS: One hundred thirty consecutive patients with OHS (56 women) who started NPPV between January 1995 and December 2006 either under stable conditions (stable group, n = 92) or during ICU management of acute hypercapnic exacerbation (acute group, n = 38) were retrospectively analyzed.
RESULTS: Arterial blood gases and the Epworth sleepiness scale were both significantly improved after 6 months of NPPV. With a mean follow-up of 4.1 +/- 2.9 years, 24 (18.5%) patients died and 24 (18.5%) discontinued NPPV. On Kaplan-Meier analysis, 1-, 2-, 3-, and 5-year survival probabilities were 97.5%, 93%, 88.3%, and 77.3%, respectively. Mortality was lower than that described in a previous series of patients with untreated OHS. Supplemental oxygen therapy was the only independent predictor of mortality. The probability of continuing NPPV was 80% at 3 years with a high rate of daily use ( > 7 h). Female sex was predictive of lower long-term adherence to NPPV. The acute and stable groups did not differ in terms of arterial blood gases and Epworth sleepiness scale at 6 months, long-term survival, and treatment adherence.
CONCLUSIONS: The results of this study support long-term NPPV as an effective and well-tolerated treatment of OHS whether initiated in the acute or chronic setting.
Authors:
Pascaline Priou; Jean-François Hamel; Christine Person; Nicole Meslier; Jean-Louis Racineux; Thierry Urban; Frédéric Gagnadoux
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-26
Journal Detail:
Title:  Chest     Volume:  138     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-08-17     Revised Date:  2011-06-20    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  84-90     Citation Subset:  AIM; IM    
Affiliation:
Département de Pneumologie, Centre Hospitalier Universitaire, Angers, France.
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MeSH Terms
Descriptor/Qualifier:
Body Mass Index
Female
Follow-Up Studies
Humans
Male
Middle Aged
Obesity Hypoventilation Syndrome / physiopathology,  therapy*
Oximetry
Oxygen Consumption
Positive-Pressure Respiration / methods*
Retrospective Studies
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Chest. 2011 May;139(5):975-7   [PMID:  21540211 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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