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Diagnostic predictors of obesity hypoventilation syndrome in sleep disordered breathing
3rd International Conference and Exhibition on Obesity & Weight Management
Vladimir M Macavei1,2, Kristofer J Spurling2, Janine Loft 2 and Himender K Makker 2
1Newham University Hospital, UK 2North Middlesex University Hospital, UK
Accepted Abstracts: J Obes Weight Loss Ther
Abstract
Background: Obesity is now considered a global epidemic, and it is projected that by the year 2025, 36% of females and 47% of males will be obese in the UK. This rise in obesity is likely to lead to an increase in respiratory consequences such as obesityhypoventilation syndrome (OHS). Obesity is also a main risk factor for obstructive sleep apnea/hypopnea syndrome (OSAHS). The need for early detection of obesity hypoventilation syndrome (OHS) is clear because delay in the diagnosis and treatment is associated with significant morbidity and mortality. Objective: To determine diagnostic predictors of OHS among obese patients with suspected OSAHS. Results: 65.5% were obese, 37.2% were morbidly obese (BMI>40 kg/m2); 52.3% had confirmed OSAHS. Hypercapnia (pCO2 >6 kPa or 45 mmHg) was present in 20.6% obese and 22.1% OSAHS patients. Analysis of OHS predictors showed significant correlations between pCO2 and BMI, FEV1, FVC, AHI, mean and minimum nocturnal SpO2, sleep time with SpO2 <90%, pO2 and calculated HCO3. PO2 and HCO3 were independent predictors of OHS explaining 27.7% of pCO2 variance (p<0.0001). A calculated HCO3 cut-off of >27 mmol/L had 85.7% sensitivity and 89.5% specificity for diagnosis of OHS, with 68.1% positive and 95.9% negative predictive value. Conclusion: Early identification of daytime hypercapnia using simple clinical predictors can avoid invasive arterial blood gas sampling and reduce morbidity and mortality associated with OHS. A normal HCO3 value may exclude daytime hypercapnia, while an elevated bicarbonate and/or nocturnal hypoxia should guide clinicians to look for OHS.Biography
Vladimir Macavei is currently working at the largest Trust in the UK, Barts Health in London. His clinical interest is primarily focused on obstructive sleep apnoea and non invasive ventilation. During a two year fellowship programme based in North London, he developed innovative research projects on obesity hypoventilation syndrome that were presented at international conferences and published in peer reviewed journals.
