Noninvasive Ventilation versus CPAP as Initial Treatment of Obesity Hypoventilation Syndrome

Annals of the American Thoracic Society
Israa SoghierBabak Mokhlesi

Abstract

Rationale: Obesity hypoventilation syndrome (OHS) is an undesirable consequence of obesity. Treatment consists of weight loss and positive airway pressure (PAP) therapy. However, the preferred mode of PAP is uncertain.Objectives: To perform a systematic review to determine whether PAP therapy should be initiated as noninvasive ventilation (NIV) or continuous PAP (CPAP) in ambulatory patients with OHS.Methods: This systematic review informed an international, multidisciplinary panel of experts who had converged to develop a clinical practice guideline on OHS for the American Thoracic Society. MEDLINE, the Cochrane Library, and Embase were searched from January 1946 to March 2019 for studies that compared initial treatment with NIV to CPAP in OHS. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to appraise the quality of evidence.Results: The search identified 2,994 potentially relevant articles, the full text of 21 articles was reviewed, and five articles were selected. The five articles included three randomized trials (one reported as two articles) and an observational study. The sample size ranged from 36 to 225 subjects. The evidence showed no differences in mortality, cardiovascular...Continue Reading

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Citations

Feb 13, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Bernie Y SunwooAtul Malhotra
Feb 29, 2020·Annals of the American Thoracic Society·Winfried Randerath
Nov 12, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Bhajan Singh
Jan 25, 2020·Annals of the American Thoracic Society·Maximiliano Tamae KakazuBabak Mokhlesi
Oct 2, 2020·Annals of the American Thoracic Society·Winfried J Randerath, Ahmed S BaHammam
Jan 7, 2020·The British Journal of Surgery·M CarronM Foletto
Jul 28, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Alejandra C LastraBabak Mokhlesi
Nov 5, 2019·American Journal of Respiratory and Critical Care Medicine·Juan F MasaUNKNOWN Spanish Sleep Network
Jan 25, 2021·Sleep Medicine Clinics·Jeremy WearnBabak Mokhlesi

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