A Successful Treatment of Obesity Hypoventilation Syndrome Using Bi-level Positive Airway Pressure in a Patient With Hypoxic Brain Damage
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We present the case of a 78-year-old female who experienced acute mental deterioration after vomiting. She showed severe hypercapnia without definite lung disease and hypoxic injury on brain image. After the acute period, she still had excessive daytime sleepiness, and the hypercapnia aggravated during the night. Polysomnography revealed severe obstructive sleep apnea, a sleep-related breathing disorder with a high apneahypopnea index of 60.2/h (mainly a hypopnea index of 59.0/h). She was diagnosed with combined obesity hypoventilation syndrome (OHS) and sleep-related breathing disorder, as the cause of daytime hypercapnia and excessive daytime sleepiness. Three months of successful bi-level positive airway pressure (BiPAP) therapy dramatically improved her daytime sleepiness and cognition. This case suggests that patients with OHS can be susceptible to hypoxic brain damage, and emphasizes the importance of the recognition and diagnosis of OHS and appropriate treatment with BiPAP therapy.
Abstract
We present the case of a 78-year-old female who experienced acute mental deterioration after vomiting. She showed severe hypercapnia without definite lung disease and hypoxic injury on brain image. After the acute period, she still had excessive daytime sleepiness, and the hypercapnia aggravated during the night. Polysomnography revealed severe obstructive sleep apnea, a sleep-related breathing disorder with a high apneahypopnea index of 60.2/h (mainly a hypopnea index of 59.0/h). She was diagnosed with combined obesity hypoventilation syndrome (OHS) and sleep-related breathing disorder, as the cause of daytime hypercapnia and excessive daytime sleepiness. Three months of successful bi-level positive airway pressure (BiPAP) therapy dramatically improved her daytime sleepiness and cognition. This case suggests that patients with OHS can be susceptible to hypoxic brain damage, and emphasizes the importance of the recognition and diagnosis of OHS and appropriate treatment with BiPAP therapy.
참고문헌 (10)
- Masa JF, "Obesity hypoventilation syndrome", Eur Respir Rev, 28, pp.180097~ (2019)[DOI]
- Iftikhar IH, "Obesity hypoventilation syndrome", Clin Chest Med, 39, pp.427~436 (2018)[DOI]
- Mokhlesi B, "Obesity hypoventilation syndrome : prevalence and predictors in patients with obstructive sleep apnea", Sleep Breath, 11, pp.117~124 (2007)[DOI]
- Lévy P, "Intermittent hypoxia and sleep-disordered breathing : current concepts and perspectives", Eur Respir J, 32, pp.1082~1095 (2008)[DOI]
- Mokhlesi B, "Assessment and management of patients with obesity hypoventilation syndrome", Proc Am Thorac Soc, 5, pp.218~225 (2008)[DOI]
- Piper AJ, "Obesity hypoventilation syndrome : mechanisms and management", Am J Respir Crit Care Med, 183, pp.292~298 (2011)[DOI]
- Higbee DH, "Cognitive impairment in COPD : an often overlooked co-morbidity", Expert Rev Respir Med, 15, pp.9~11 (2021)[DOI]
- Ramanantsoa N, "Congenital central hypoventilation syndrome", Respir Physiol Neurobiol, 189, pp.272~279 (2013)[DOI]
- Kumar R, "Neuroanatomic deficits in congenital central hypoventilation syndrome", J Comp Neurol, 487, pp.361~371 (2005)[DOI]
- Huang BY, "Hypoxic-ischemic brain injury : imaging findings from birth to adulthood", Radiographics, 28, pp.417~439 (2008)[DOI]