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Obesity-hypoventilation syndrome: Early diagnosis and immediate intervention – a case report

Sergio Roberto Nacif, Isabella de Carvalho Aguiar, Ezequiel Fernandes Oliveira, Nadua Apsotolico, Israel dos Santos dos Reis, Ismael Souza Dias, Claudio F. Donner, Luis Vicente Franco Oliveira

Med Sci Tech 2012; 53(3): CR143-147

ID: 883614

Background:    Obesity is becoming a major medical concern in many parts of the world, and leads to a number of sleep-disordered breathing patterns, such as obstructive sleep apnea and obesity hypoventilation syndrome. Obesity and untreated obstructive sleep apnea have been linked to various health conditions, including diabetes, cardiovascular disease, and premature death.
    Case Report:    We present the case of a morbidly obese 45-year-old man, admitted to the respiratory unit with cyanosis of the extremities, dyspnea, weakness, pain in the legs and abdomen, and swelling in both upper limbs, reporting a worsening of symptoms in the previous week.
    Conclusions:    This patient reported a substantial improvement in sleep quality, with the absence of snoring, no signs of excessive daytime sleepiness, and a significant reduction in polyglobulia, with hemoglobin at 17.8 g% and hematocrits at 52%. On the last return to the clinic, after 4 months of progress, the patient exhibited 91% SpO2 in ambient air and reported no oxygen support or shortness of breath during activities of daily living. Quick recognition and intervention with noninvasive ventilation therapy has proven effective in reducing PaCO2 and increasing PaO2, as well as improvements gas exchange, lung volume, and SpO2 during sleep.

Keywords: Obesity-hypoventilation syndrome, Quality of Life, Polysomnography, Sleep disorders breathing, positive airway pressure

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