Subscribe to RSS
DOI: 10.1055/s-0037-1617703
Therapie des Obesitas-Hypoventilationssyndroms (OHS)
Treatment of obesity-hypoventilation syndromePublication History
Publication Date:
29 December 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034923/201602/lookinside/thumbnails/10-1055-s-0037-1617703-1.jpg)
Zusammenfassung
Patienten mit Obesitas-Hypoventilationssyndrom haben eine ausgeprägte klinische Beschwerdesymptomatik und eine erhöhte Sterblichkeit. Vor diesem Hintergrund ist eine frühzeitige und auch konsequente Therapie notwendig. In aller Regel wird eine Atmungstherapie mit CPAP oder sogar eine nicht-invasive Beatmung eingeleitet. Flankierend ist eine Gewichtsreduktion erforderlich. Hier kommen diätetische, in ausgesuchten Fällen auch operative Maßnahmen zum Einsatz.
Summary
Patients with obesity hypoventilation syndrome suffer from various clinical symptoms and have an increased mortality risk. Early and consequent treatment is therefore necessary. As a rule, treatment with CPAP or even non-invasive ventilation is required, supported by weight reduction, usually by dietary measures or, in particular cases, by bariatric surgery.
-
Literatur
- 1 Banerjee D. et al. Obesity hypoventilation syndrome: hypoxemia during continuous positive airway pressure. Chest 2007; 131: 1678-1684.
- 2 Berger K. et al. Obesity hypoventilation syndrome as a spectrum of respiratory disturbances during sleep. Chest 2001; 120: 1231-1238.
- 3 Brolin RE. Bariatric surgery and long-term control of morbid obesity. JAMA 2002; 288: 2793-2796.
- 4 Budweiser S. et al. Mortality and prognostic factors in patients with obesity-hypoventilation syndrome undergoing noninvasive ventilation. J Intern Med 2007; 261: 375-383.
- 5 de Lucas-Ramos P. et al. Benefits at 1 year of nocturnal intermittent positive pressure ventilation in patients with obesity-hypoventilation syndrome. Respir Med 2004; 98: 961-967.
- 6 Windisch W. et al. Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e. V., S2 - Leitlinie Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz. Pneumologie 2010; 64: 207-240.
- 7 Douketis JD. et al. Does the type of hormone replacement therapy influence the risk of deep vein thrombosis? A prospective case-control study. J Thromb Haemost 2005; 03: 943-948.
- 8 Ebeo CT. et al. The effect of bi-level positive airway pressure on postoperative pulmonary function following gastric surgery for obesity. Respir Med 2002; 96: 672-676.
- 9 Fernandez Jr AZ. et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg 2004; 239: 698-702.
- 10 Heinemann F. et al. Noninvasive positive pressure ventilation improves lung volumes in the obesity hypoventilation syndrome. Respir Med 2007; 101: 1229-1235.
- 11 Huerta S. et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. J Gastrointest Surg 2002; 06: 354-358.
- 12 Johanson K. et al. Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ 2009 Dec 3; 339: b4609.
- 13 Kim SH. et al. Evaluation of patients with sleep apnea after tracheotomy. Arch Otolaryngol Head Neck Surg 1998; 124: 996-1000.
- 14 Kimura et al. Progesterone therapy for sleep apnea syndrome evaluated by occlusion pressure responses to exogenous loading. Am Rev Respir Dis 1989; 139: 1198-1206.
- 15 Masa JF. et al. Noninvasive positive pressure ventilation and not oxygen may prevent overt ventilatory failure in patients with chest wall diseases. Chest 1997; 112: 207-213.
- 16 Masa JF. et al. The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation. Chest 2001; 119: 1102-1107.
- 17 Mokhlesi B. Positive airway pressure titration in obesity hypoventilation syndrome: CPAP or bilevel PAP?. Chest 2007; 131: 1624-1626.
- 18 Mohklesi B. Impact of adherence with positive airway pressure therapy on hypercapnia in obstructive sleep apnea. J Clin Sleep Med 2006; 15; 02: 57-62.
- 19 Mohklesi B. Recent advances in obesity hypoventilation syndrome. Chest 2007; 132: 1322-1336.
- 20 Perez de Llano LA. et al. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity hypoventilation syndrome. Chest 2005; 128: 587-594.
- 21 Pillar G. et al. Recurrence of sleep apnea without concomitant weight increase 7.5 years after weight reduction surgery. Chest 1994; 106: 1702-1704.
- 22 Piper A. et al. Obesity hypoventilation syndrome: therapeutic implications for treatment. Expert Rev Respir Med 2010; 04: 57-70.
- 23 Rapoport DM. et al. Hypercapnia in the obstructive sleep apnea syndrome: a reevaluation of the “Pickwickian syndrome”. Chest 1986; 89: 627-635.
- 24 Stepanski EJ. et al. The need for a standardized CPAP titration protocol and follow-up procedures [letter]. J Clin Sleep Med 2005; 01: 311.
- 25 Sugerman HJ. et al. Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 1992; 55: 597S-601S.
- 26 Sutton Jr FD. et al Progesterone for outpatient treatment of Pickwickian syndrome. Ann Intern Med 1975; 83: 476-479.
- 27 Thorne SA. et al. Management of polycythaemia in adults with cyanotic congenital heart disease. Heart 1998; 79: 315-316.
- 28 Verse T. et al. Bariatric surgery for obstructive sleep apnea. Chest 2005; 128: 485-487.
- 29 Tojima H. et al. Effects of acetazolamide in patients with the sleep apnoea syndrome. Thorax 1988; 43: 113-119.
- 30 Whyte KF. et al. Role of protriptyline and acetazolamide in the sleep apnea/hypopnea syndrome. Sleep 1988; 11: 463-472.