Neural respiratory drive and cardiac function in patients with obesity hypoventilation syndrome following initiation of non-invasive ventilation

作者：Onofri Angelo; Patout Maxime; Kaltsakas Georgios^*; Lhuillier Elodie; Mushemi Blake Sitali; Arbane Gill; Pengo Martino F; Marino Philip; Steier Joerg

来源：Journal of Thoracic Disease, 2018, 10(S1): S135-+.

DOI：10.21037/jtd.2017.12.129

• Obesity hypoventilation syndrome (OHS)
• neural respiratory drive (NRD)
• sleep-disordered breathing
• non-invasive ventilation (NIV)
• respiratory muscle function
• pulmonary hypertension (PH)

Background: Chronic hypercapnic respiratory failure (HRF) in obesity hypoventilation syndrome (OHS) is commonly treated using non-invasive ventilation (NIV). We hypothesised that treatment of OHS would improve neural respiratory drive index (NRDI) and cardiac function.
Methods: Fourteen patients (8 females) with OHS, who were admitted for initiation of domiciliary NIV, were prospectively studied. Patients had (mean +/- SD): age (53 +/- 10 years), body mass index (BMI) (50.1 +/- 10.8 kg/m(2)), and pCO(2) (7.3 +/- 0.9 kPa). NRDI was assessed by surface electromyogram of the parasternal intercostals. Cardiac function was assessed by transthoracic echocardiography (TTE). All measurements were performed at baseline, 6 weeks, and 3 months.
Results: NRDI improved on day one following NIV set-up comparing to baseline (484.2 +/- 214.8 vs. 316.5 +/- 106.5 AU) and this improvement was maintained at 6 weeks (369.1 +/- 173.2 AU) and at 3 months (351.2 +/- 167.1 AU) (P=0.004). No significant differences were identified in terms of cardiac function between baseline and 3 months [tricuspid annular plane systolic excursion (TAPSE) (24.6 +/- 5.8 vs. 23.0 +/- 4.0 mm, P=0.317); systolic pulmonary artery (PA) pressures (36.7 +/- 15.2 vs. 44.5 +/- 23.9 mmHg, P=0.163].
Conclusions: NIV improves NRDI in patients with OHS, while the cardiac function over a three-month period remains unchanged.

• 出版日期2018-1