Obesity hypoventilation syndrome Pickwickian syndrome

Obesity hypoventilation syndrome
  • Facts:
    Severe obesity ( greater than 150 % of ideal body weight)

  • History / PE:
    Extreme obesity
    Thick neck
    Distant heart sounds
    Low voltage QRS complexes
  • Diagnosis:
    Alveolar hypoventilation during wakefullness
    Chronic hypercapnic, hypoxic respiratory failure
    Respiratory acidosis
    Secondary erythrocytosis
  • Treatment:
    Weight loss
    Ventilator support
    Oxygen therapy
    Progestins (respiratory stimulant)
  • Complications:
    Pulmonary hypertension with cor pulmonale
  • Notes:
    In compensatory effort to maintain normal pH, the kidneys increase bicarbonate retention and decrease chloride reabsorption

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August 5th 2010