Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome

doi:10.1016/0002-9343(75)90392-7

The American Journal of Medicine

Volume 59, Issue 3, September 1975, Pages 343-348

https://doi.org/10.1016/0002-9343(75)90392-7 Get rights and content

Abstract

Most patients with extreme obesity do not exhibit alveolar hypoventilation, but an intriguing minority do. The mechanism(s) of this phenomenon remain unknown. A disorder in ventilatory control has been suggested as a major factor in the pathogenesis of the obesity-hypoventilation syndrome. Accordingly, hypoxic and hypercapnic ventilatory drives were measured in 10 patients with the typical symptoms of the syndrome: obesity, hypersomnolence, hypercapnia, hypoxemla, polycythemia and cor pulmonale. Hypoxic ventilatory drive, measured as the shape parameter A, averaged 21.9 ± 5.35, approximately one-sixth that in normal controls, A = 126 ± 8.6 (P < 0.01). The ventilatory response to hypercapnia also was markedly reduced, the slope of the response averaging 0.51 ± 0.005, or about one-third the normal value of 1.83 ± 0.13 (P < 0.01). This decreased responsiveness in hypoxic and hypercapnic ventilatory drive was consistent throughout the group. The depression in ventilatory drive found in the obesity-hypoventilatlon syndrome may be causally related to the alveolar hypoventilation manifested by these patients.

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^☆: This study was supported by National Institutes of Health Program Project Grant HL-14985-03 and Intensive Respiratory Care and Rehabilitation Grant HL-04933, Bethesda, Maryland.

¹: From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.

^∗: Present address: Mercy Hospital, Birmingham, Alabama.

^†: Present address: U.S. Army Medical Corps, Bremen, Germany.

^§: Recipient of Research Career Development Award.

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Clinical studyDecreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome☆

Abstract

Am J Med

Am J Med

Am J Med

Respir Physiol

Am J Med

Extreme obesity associated with alveolar hypoventilation—A Pickwickian syndrome

Am J Med

Respiratory Function in Disease

Ventilatory insufficiency in extreme obesity

Acta Med Scand

Respiratory control and work of breathing in obese patients

J Appl Physiol

The red cell mass-arterial oxygen relationship in normal man

J Clin Invest

Hypoxic ventilatory drive in normal man

J Clin Invest

A modified fuel cell for the analysis of oxygen concentration of gases

J Appl Physiol

Clinical method for assessing the ventilatory response to carbon dioxide

Aust NZ J Med

Introduction to Statistical Analysis

Clinical study
Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome☆