Background: Obese hypoxemic patients have a high prevalence of sleep disordered breathing (SDB). It is unclear to what extent treatment of SDB can improve daytime hypoxemia.
Methods: We performed a retrospective cohort study of obese hypoxemic individuals, all of whom underwent polysomnography, arterial blood gas analysis, and subsequent initiation of positive airway pressure (PAP) therapy for SDB. Patients were followed for one year for change in partial pressure of arterial oxygen and the need for supplemental oxygen.
Results: One hundred and seventeen patients were treated with nocturnal PAP and had follow-up available. Adherence to PAP was satisfactory in 60%, and was associated with a significant improvement in daytime hypoxemia and hypercapnea; 56% of these patients were able to discontinue supplemental oxygen. Adherence to PAP therapy and the baseline severity of OSA predicted improvement in hypoxemia, but only adherence to PAP therapy predicted liberation from supplemental oxygen.
Conclusions: The identification and treatment of SDB in obese hypoxemic patients improves daytime hypoxemia. It is important to identify SDB in these patients, since supplemental oxygen can frequently be discontinued following treatment with PAP therapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599852 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140135 | PLOS |
Heart Lung
January 2025
Pulmonary & Critical Care Division, Hotel Dieu de France, Saint Joseph University of Beirut, Beirut, Lebanon. Electronic address:
Background: During the COVID-19 pandemic, intensive care units (ICUs) experienced a surge in patients with viral pneumonia, often leading to acute respiratory failure. A global rise in ICU superinfections was observed; however, it remains unclear whether the extensive use of broad-spectrum antibiotics, corticosteroids, and immunosuppressants contributed to this rise.
Objectives: We aim to identify clinical factors associated with these superinfections while analyzing epidemiologic patterns of superinfections in two different periods.
Intensive Crit Care Nurs
February 2025
Respiratory Intermediate Care Unit, "Enfermera Isabel Zendal" Emergency Hospital, Madrid, Spain; Department of Pneumology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Hospital Unviersitario la Princesa, Spain. Electronic address:
Backward: The COVID-19 pandemic has severely tested global health systems. Non-invasive respiratory support, especially combining high-flow nasal cannula (HFNC) and continuous positive airway pressure, has effectively treated COVID-19 induced Acute Hypoxemic Respiratory Failure and reduced mortality. However, HFNC alone is more comfortable, better tolerated, and less costly than non-invasive ventilation.
View Article and Find Full Text PDFMed Intensiva (Engl Ed)
November 2024
Grupo Internacional de Ventilación Mecánica, WeVent, Spain; Critical Care Unit, Hospital Biprovincial Quillota-Petorca, Chile.
Intensive Care Med
August 2024
Medical Information, IMAG, CNRS, Univ Montpellier, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France.
Purpose: Although noninvasive ventilation (NIV) may reduce reintubation in patients with acute hypoxemic respiratory failure following abdominal surgery, this strategy has not been specifically assessed in patients with obesity.
Methods: We conducted a post hoc analysis of a multicenter randomized controlled trial comparing NIV delivered via facial mask to standard oxygen therapy among patients with obesity and acute hypoxemic respiratory failure within 7 days after abdominal surgery. The primary outcome was reintubation within 7 days.
Respir Med Case Rep
January 2024
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
The ventilatory management of morbidly obese patients presents an ongoing challenge in the Intensive Care Unit (ICU) as multiple physiologic changes in the respiratory system complicate weaning efforts and make extubation more difficult, often leading to increased time on the ventilator. We report the case of a young adult male who presented to our ICU on two separate occasions with hypoxemic respiratory failure requiring intubation. Esophageal manometry (EM) guided positive end expiratory pressure (PEEP) titration was utilized during both ICU admissions to improve oxygenation and aid in extubation with spontaneous breathing trials performed on higher-than-normal PEEP settings and successful liberation on both occasions.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!