논문KCI 등재
비만성 저환기 증후군의 조기 진단 및 치료 전략
Early Diagnosis and Treatment Strategies of Obesity Hypoventilation Syndrome
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참고문헌
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주제분류정신과학
초록
많은 수의 비만성 저환기증후군 환자들은 조기 진단 및 적 절한 치료를 받지 못하다, 만성 호흡 부전의 급성 악화로 인 해 응급한 상황에서 진단되는 경우가 많다. 이런 경우 안정된 비만성 저환기증후군 환자보다 더 높은 단기 사망률을 보이며, 중환자실 입원 및 인공호흡기 치료를 받을 가능성도 증가한다. 치료받지 않은 비만성 저환기증후군 환자들의 사망률은 높은 편이며, 심혈관 질환의 이환율과 상관을 보이는 것으로 알려져 있다. 따라서, 비만성 저환기증후군 환자의 특성 및 병태생리학적 기전을 알고, 조기 진단 및 적절한 치료를 하는 것이 예후를 개선하는데 중요하다.
Abstract
Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m2), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.
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