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

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

References (28)

  • JV Weil et al.

    Hypoxic ventilatory drive in normal man

    J Clin Invest

    (1970)
  • JV Weil et al.

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

    J Appl Physiol

    (1967)
  • DJC Read

    Clinical method for assessing the ventilatory response to carbon dioxide

    Aust NZ J Med

    (1967)
  • WJ Dixon et al.

    Introduction to Statistical Analysis

    (1957)
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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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