AI Article Synopsis
- * Factors linked to continued hypercapnia included being older, having a lower BMI, and more comorbid conditions; female patients were also more likely to persist in this state.
- * The study identified sex, BMI, carbon dioxide levels at diagnosis, and total lung capacity as independent risk factors for ongoing hypercapnia in patients using non-invasive ventilation at home.
Article Abstract
Obesity-hypoventilation syndrome (OHS) is a respiratory complication of obesity characterized by chronic hypercapnic respiratory failure. It is often associated with several comorbidities and is treated by positive airway pressure (PAP) therapy. This study aimed to identify factors associated with persistent hypercapnia in patients receiving home non-invasive ventilation (NIV). We performed a retrospective study including patients with documented OHS. In total, 143 patients were included (79.7% women, age 67 ± 15.5 years, body mass index 41.6 ± 8.3 kg/m). After 4.6 ± 4.0 years of follow-up, 72 patients (50.3%) remained hypercapnic. In bivariable analysis, clinical data showed no difference in follow-up duration, number of comorbidities, comorbidities, or circumstance of discovery. Patients with persistent hypercapnia on NIV were generally older, with lower BMI and more comorbidities. (5.5 ± 1.8 versus 4.4 ± 2.1, = 0.001), female sex (87.5% versus 71.8%), was treated by NIV (100% versus 90.1%, < 0.01), had lower FVC (56.7 ± 17.2 versus 63.6 ± 18% of theoretical value, = 0.04), lower TLC (69.1 ± 15.3 versus 74.5 ± 14.6% of theoretical value, = 0.07), lower RV (88.4 ± 27.1 versus 102.5 ± 29.4% of theoretical value, = 0.02), higher pCO2 at diagnosis (59.7 ± 11.7 versus 54.6 ± 10.1 mmHg, = 0.01) and lower pH (7.38 ± 0.03 versus 7.40 ± 0.04, = 0.007), higher pressure support (12.6 ± 2.6 versus 11.5 ± 2.4 cmHO, = 0.04) and lower EPAP (8.2 ± 1.9 versus 9 ± 2.0 cmHO, = 0.06). There was no difference in non-intentional leaks and daily use between patients between both groups. By multivariable analysis, sex, BMI, pCO2 at diagnosis, and TLC were independent risk factors for persistent hypercapnia on home NIV. In individuals with OHS, persistent hypercapnia on home NIV therapy is frequent. Sex, BMI, pCO2 at diagnosis, and TLC were all associated with an increased risk of persistent hypercapnia in persons treated with home NIV.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218859 | PMC |
| http://dx.doi.org/10.3390/jcm12103381 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical benefit of chronic non-invasive ventilation in severe stable COPD: a matter of persistent hypercapnia improvement.
Thorax
January 2025
Department of Pulmonology and Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Purpose: In patients with chronic obstructive pulmonary disease (COPD) treated with chronic non-invasive ventilation (NIV), the relation between improvements in nocturnal transcutaneous partial pressure of CO (PtcCO) and daytime arterial partial pressure of CO (PaCO) remains uncertain. Also, to what extent improvements in nocturnal PtcCO result in better health-related quality of life (HRQL), exercise capacity, lung function and survival has not been investigated.
Patients And Methods: Patients with COPD who were initiated on chronic NIV were prospectively followed for 6 months.
Weaning of non COPD patients at high-risk of extubation failure assessed by lung ultrasound: the WIN IN WEAN multicentre randomised controlled trial.
Crit Care
November 2024
Biostatistics Unit, Department of Clinical Research and Innovation (DRCI), CHU Clermont-Ferrand, Clermont-Ferrand, France.
Background: Postextubation respiratory failure (PRF) frequently complicates weaning from mechanical ventilation and may increase morbidity/mortality. Noninvasive ventilation (NIV) alternating with high-flow nasal oxygen (HFNO) may prevent PRF.
Methods: Ventilated patients without chronic obstructive pulmonary disease (COPD) and at high-risk of PRF defined as a lung ultrasound score (LUS) ≥ 14 assessed during the spontaneous breathing trial, were included in a French-Chinese randomised controlled trial.
Pitfalls in the Evaluation of Respiratory Failure in Myasthenia Gravis Patients: A Case Series.
Neurohospitalist
August 2024
Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.
Article Synopsis
- - The study focuses on the need to identify various causes of respiratory failure in myasthenia gravis (MG) patients, considering both myasthenic and non-myasthenic factors.
- - Three case studies are presented, highlighting different respiratory failure presentations: hypercarbic respiratory failure in a long-term MG patient, glottal stenosis in another MG patient, and hypoxia due to a patent foramen ovale in an elderly MG patient.
- - The findings stress the importance of thorough clinical evaluation, as symptoms of respiratory distress may not always be apparent in MG, and alternative causes of hypoxia should be investigated.
Interactions between Arousal State and CO Determine the Activity of Central Chemoreceptor Neurons That Drive Breathing.
J Neurosci
January 2025
Department of Pharmacology, University of Virginia, Charlottesville, Virginia 22908
The homeostatic regulation of pulmonary ventilation, and ultimately arterial PCO, depends on interactions between respiratory chemoreflexes and arousal state. The ventilatory response to CO is triggered by neurons in the retrotrapezoid nucleus (RTN) that function as sensors of central pH, which can be identified in adulthood by the expression of Phox2b and neuromedin B. Here, we examine the dynamic response of genetically defined RTN neurons to hypercapnia and arousal state in freely behaving adult male and female mice using the calcium indicator jGCaMP7 and fiber photometry.
View Article and Find Full Text PDFImpact of outpatient adaptation to home mechanical ventilation on health-related quality of life in patients with COPD: the OutVent study.
ERJ Open Res
September 2024
Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal.
Background: Home mechanical ventilation (HMV) is indicated in patients with severe hypercapnic COPD. Initiation of HMV commonly occurs during an inpatient period, but there has been increasing interest for outpatient adaptation. This study aimed to evaluate the outpatient initiation and adaptation of HMV and its impact on health-related quality of life (HRQoL) in patients with severe COPD.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!