Correlates of obesity-related chronic ventilatory failure

• Published in: BMJ open respiratory research 2016, Vol.3 (1), p.e000110-e000110
• Main Authors: Manuel, Ari R, Hart, Nicholas, Stradling, John R
• Format: Article
• Language: English
• Subjects: Abdomen; Body mass index; Carbon dioxide; Gastrointestinal surgery; Hypoxia; Lung diseases; Mortality; Neuromuscular diseases; Obesity; Respiration; Sleep; Ventilation; Vitamin D
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2015-000110

IntroductionOnly a third of obese patients develop chronic ventilatory failure. This cross-sectional study assessed multiple factors potentially associated with chronic ventilatory failure.Materials/patients and methodsParticipants had a body mass index (BMI) >30 kg/m2, with or without chronic ventilatory failure (awake arterial partial pressure of carbon dioxide >6 kPa or base excess (BE) ≥2 mmols/L). Factors investigated were grouped into domains: (1) obesity measures, (2) pulmonary function, (3) respiratory and non-respiratory muscle strength, (4) sleep study derivatives, (5) hypoxic and hypercapnic responses, and (6) some hormonal, nutritional and inflammatory measures.Results71 obese participants (52% male) were studied over 27 months, 52 (SD 9) years and BMI 47 (range 32–74) kg/m2. The best univariate correlates of BE from each domain were: (1) dual-energy X-ray absorptiometry measurement of visceral fat (r=+0.50, p=0.001); (2) supine forced expiratory volume in 1 s (r=−0.40, p=0.001); (3) sniff maximum pressure (r=−0.28, p=0.02); (4) mean overnight arterial oxygen saturation (r=−0.50, p