obesityhypoventilaatiooireyhtymässä

Obesity hypoventilation syndrome, also known as Pickwickian syndrome, is a respiratory disorder characterized by alveolar hypoventilation in an obese individual. This means that the lungs do not adequately exchange oxygen and carbon dioxide. The primary cause is obesity, particularly extreme obesity, which leads to reduced lung volumes and increased work of breathing.

The syndrome is typically diagnosed in individuals with a body mass index (BMI) of 30 kg/m2 or higher who also exhibit chronic hypercapnia (elevated carbon dioxide levels in the blood) and hypoxemia (low oxygen levels in the blood) that are not attributable to other lung diseases. Symptoms can vary but often include daytime sleepiness, morning headaches, shortness of breath, fatigue, and snoring. In severe cases, individuals may experience symptoms of heart failure, such as swelling in the legs and ankles.

The pathophysiology involves mechanical factors related to excess adipose tissue, which can impede chest wall movement and diaphragm function. Additionally, impaired respiratory drive and changes in lung mechanics contribute to the hypoventilation. Obstructive sleep apnea is frequently present in individuals with obesity hypoventilation syndrome, exacerbating the respiratory compromise.

Treatment focuses on weight loss, which is the most effective long-term solution. Non-invasive positive pressure ventilation, such as CPAP or BiPAP, is commonly used to support breathing during sleep and wakefulness, helping to normalize blood gas levels. Other management strategies may include exercise programs, dietary changes, and addressing any co-existing medical conditions. Early diagnosis and intervention are crucial to prevent serious complications.