Obesity Hypoventilation Syndrome is characterized by obesity, hypercapnia, and respiratory issues while asleep that occurs in the absence of any other pathology that could cause respiratory failure (Castillejo et al., 2015, p. 63). It is usually defined as an awake PaCO2 of greater than 45mmHg and a body mass index of greater than 30kg (Piper, 2015, p. 9). This is a life threatening disorder that can lead to death if not treated properly and aggressively. Treatments include CPAP (continuous positive airway pressure), NIV (non-invasive ventilation), and lifestyle changes such as weight loss and exercise. Obesity Hypoventilation Syndrome is becoming more prevalent in our society due to the increased occurrence of morbid obesity. Obesity is recognized
The dangers of the obesity epidemic are overwhelming and the percentage of the population which suffers from this condition is increasing exponentially with the increased use of HFCS. Especially in the United States, where almost a third of the adult population is obese, the problems with obesity are readily becoming more apparent. Researchers predict that about 30 serious medical conditions can arise due to obesity. Some of these complications are type II diabetes, high blood pressure, coronary heart disease, and arthritis. Problems can also extend to hypertension, birth defects, increased chances of various cancers, and impaired mobility.
Obstructive Sleep Apnea Syndrome is a common comorbidity that can have detrimental results on patient safety in the perioperative phase. Symptoms of OSA include daytime somnolence, loud snoring, and irritability. Obesity and anatomic abnormalities are considered risk factors of this sleep disorder. (Brousseau, Dobson, & Milne, 2014). OSA is characterized by periods of apnea during sleep which are caused by obstruction of the upper airway. The obstruction can be partial or complete and places a patient at a high risk for complications in conjunction with general anesthesia. OSA occurs in 28% of women and 38% of men and the rate increases with a BMI > 40. (AORN, 2014). Currently, with the exception of patients
This patient comes to the office complaining of shortness of breath that has increased over the past month, waking up frequently in the middle of the night with acute shortness of breath, and reports feeling tired most of the time. According to McCance & Huether (2014), obstructive sleep apnea syndrome (OSAS) can cause interrupted sleep patterns and excessive day-time sleepiness. In addition, McCance & Huether (2014) reports that OSAS contributes to the development of metabolic syndrome, which is highly associated with cardiovascular disease mortality and states, “If left untreated it also can cause cardiovascular disease, particularly left ventricular hypertrophy, and insulin resistance, as well with pulmonary complications” (p. 1300).
Components, for example, decreased action levels and expanded ravenousness, especially for refined sugars, might possibly add to weight pick up in OSA patients. Whether OSA inclines to particular collection of instinctive fat stays to be resolved. CPAP treatment of OSA diminishes the measure of instinctive fat (as measured by stomach CT examining), even in patients without huge weight reduction. At long last, there are information demonstrating significant cover in hereditary substrates in the middle of OSA and weight. Patel et al reported a critical connection in the middle of's AHI and human adiposity measures (going from 0.57 to 0.61), proposing that heftiness could clarify about 40% of the hereditary change in rest apnea. In another study, Popko et al demonstrated that polymorphisms (Arg/Arg and Gln/Arg when contrasted and Gln/Gln) of the leptin receptor, which is included in vitality homeostasis and body weight regulation, are essentially related with both OSA and stoutness when contrasted and sound controls. These studies propose that hereditary polymorphisms may impact both rest apnea and corpulence, and may be essentially interrelated in the improvement of these
OSA is a common disorder that is caused by intermittent collapse of upper airway during sleep leading to brain arousal, changes in intrathoracic pressure, and intermittent episodes of hypoxemia and reoxygenation. OSA is increasingly being recognized as a major public health burden, with a strong focus on the associated cardiovascular risk (Phillips and O'Driscoll, 2013).
This is important because some of the effects from those suffering from OSA are cardiovascular diseases. The first is high blood pressure. Most studies show a link between the two and left untreated could lead to arterial diseases. This could lead to a stroke which is related to OSA and hypertension. Finally, low oxygen levels in the blood are a product of OSA. As stated before, patients stop breathing which in turn cause a hypoxic event. The interesting thing about this is the heart can physically change. It may become enlarged due to chronic
According to the National Institutes of Health, “Obesity and overweight together are the second leading cause of preventable death in the United States. An estimated 300,000 deaths per year are due to the obesity epidemic.” When people become severely overweight it affects every part of their body. In this first ad, the method of self-slaughter is hanging, or asphyxiation. The two systems that are most greatly affected by both obesity and asphyxiation alike, are the cardiovascular and respiratory system. Under the weight of their own bodies, it is difficult for the lungs to function properly taking in oxygen and pumping oxygenated blood through the body. Having an excessive amount of intra-abdominal, or belly fat “affects your blood pressure; your blood lipid levels and interferes with your ability to use insulin effectively. You use insulin to process glucose derived from food, our body 's primary fuel. If you cannot use insulin properly you may develop diabetes, a risk factor of cardiovascular disease.” The cardiovascular system suffers greatly due to the increase of fat in the body; coronary artery disease, congestive heart failure, and other cardiac diseases are very common causes of death in the obese
As a practicing doctor it is important to episode with patience so they will be no missed diagnosis, as there was in the case with a patient who had shortness of breath. The doctor informed there was too much pressure from her weight pressing on her chest. It turns out that the patient was suffering from several blog clots in her lungs. If the doctor was to look beyond there obesity, he might have diagnosed her
One study concluded that almost 75 % of asthma patients seeking emergency room treatment were overweight or obese (Jilcy, Aronow, Chandy, 2012). Being obese or overweight can lead to a compromise in ventilation and restrictions in tidal volume (VT). Studies have show that weight loss eases symptoms of asthma and if possible a weight loss program should be implemented (Jilcy et al., 2012).
Obesity is a leading risk factor for OSA, as weight increases the risk of OSA increases as well. The prevalence of OSA in obese patients is almost twice compared to normal weight patients. As a patient gains 10% of their weight their risk of developing OSA increase by 6. It is estimated that almost 25% of adults with a BMI between 25-28kg.m2 have some form of OSA. Being overweight can worsen OSA due to fat deposition in specific spots that may induce apnea. Patients who are overweight have additional fat tissue by the upper airway causing an increase in collapsibility leading to apnea events. In addition, the fat deposits around the trunk reduce the chests functioning leading to an increase in oxygen demand.
Obstructive sleep apnea is the most common form between both sleep apneas. OSA occurs when the upper airway collapse during sleep. Collapse of the upper airway may cause decreases in ventilation, but not complete cessation of it, with desaturation and arousal (hypopnea) and/or complete cessation of airflow for more than 10 seconds entitled apnea (Figure 1) 1. Common symptoms of OSA are frequent arousal, snoring, choking/gasping, daytime sleepiness, increased carbon dioxide (CO2) in the blood (hypercapnea), and a decrease of oxygen level in the body (hypoxia). As stated before, OSA is more common in men than in women. Other factors that influence OSA are those with an increased body mass index, thick neck/circumference, small erythematous oropharynx, position of body during sleep (most commonly the supine position), medication, alcohol, or pre-existing cardiac complications2. Usually, OSA is diagnosed by a sleep doctor monitoring the patient during a polysomnography (sleep study). Having a sleep study done is the gold standard diagnostic for assessing sleep-disordered breathing. There is monitoring of the airflow of the nose and mouth, end tidal CO2, the patient’s sleep state by electroencephalography, movement of the chest and abdomen, pulse oximetry, and blood pressure. “The apnea-hypopnea index (AHI)—the number of obstructive events per hour—is the most commonly used measurement to quantify OSA: mild OSA = 5 to 15 events/hour; moderate = 15 to 30
Hypemic hypoxia hypoxia is caused by the reduced ability of the blood to carry oxygen. To the pilot, this means that, even though there is an adequate supply of oxygen to breathe, the blood's capacity to carry the oxygen to the cells has been impaired. There are a variety of reasons for this to happen. Anemia, hemorrhage, hemoglobin abnormalities, sulfa drugs, nitrites, and carbon monoxide interfere with the ability of the blood to carry oxygen, reducing the amount of oxygen the blood can carry to the cells. The most common cause for hypemic hypoxia in aviation is when carbon monoxide is inhaled because of aircraft heater malfunctions, engine manifold leaks, or cockpit contamination with exhaust from other aircraft. Hemoglobin bonds with carbon
Obesity is a condition where the body amasses an excessive amount of adipose tissue (DeAngelo, Kalumuck, & Adlin, 2014). The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health”. It is an avoidable disease that has increased almost twofold since 1980 (Obesity and Overweight, 2014). Obesity affects myriad body systems or parts of anatomy, including the abdomen, blood vessels, circulatory system, endocrine system, gastrointestinal system, heart, intestines, joints, psychic-emotional system, respiratory system, and stomach (DeAngelo, Kalumuck, & Adlin). Many diseases arise due to obesity complications, such as
Lawrence & Lawrence (2013) state, in order to diagnose MetS, an individual must shows signs of central obesity as well as 2 or more of the following risk factors: raised triglycerides, low count of high-density lipoproteins (HDLs)/dyslipidemia, high blood pressure, and a high fasting plasma glucose. It depends on the patient, but all of these risk factors can be controlled through diet and exercise. In some cases, however, the risk factors may be congenital. This syndrome normally starts with weight gain around the abdominal region (central obesity) as well as development of glucose intolerance (Lawrence & Lawrence, 2013). It is clear to see how the development of these two disease interconnect with the rest of the criteria for MetS. For example, it is known that obese individuals generally show increased blood pressure, increased triglyceride counts, and low HDL counts due to poor diet and exercise habits.