Obesitas-Hypoventilationssyndrom (OHS)

S. Böing; W. J. Randerath

doi:10.1055/s-0037-1617701

Adipositas - Ursachen, Folgeerkrankungen, Therapie, Table of Contents

Adipositas - Ursachen, Folgeerkrankungen, Therapie 2016; 10(02): 93-97
DOI: 10.1055/s-0037-1617701

Übersichtsarbeit

Schattauer GmbH

Obesitas-Hypoventilationssyndrom (OHS)

Epidemiologie, Pathophysiologie, Diagnostik und FolgeerkrankungenObesity hypoventilation syndromeEpidemiology, pathophysiology, diagnostics and associated diseases

Authors

S. Böing

¹Klinik für Pneumologie und Allergologie, Schlaf- und Beatmungsmedizin, Bethanien Krankenhaus Solingen
W. J. Randerath

¹Klinik für Pneumologie und Allergologie, Schlaf- und Beatmungsmedizin, Bethanien Krankenhaus Solingen

Abstract

Zusammenfassung

Das Obesitas-Hypoventilationssyndrom (OHS) ist eine mit Adipositas assoziiert auftretende Störung des Atmungssystems. Sie ist definiert über eine Hyperkapnie im Wachzustand (chronisch erhöhter arterieller Kohlendioxidpartialdruck (PaCO₂) >45 mmHg) bei Vorliegen eines Body-Mass-Index (BMI) ≥ 30 kg/m². Andere Atmungsstörungen, die eine Hypoventilation erklären könnten, müssen zur Diagnosestellung eines OHS ausgeschlossen werden. Ein-schränkungen der Lungenfunktion, Störungen des zentralen Atemantriebs und schlafbezoge-ne Atmungsstörungen gelten als zentrale Faktoren in der Pathophysiologie des OHS. Vor dem Hintergrund der durch das OHS deutlichen gesteigerten Morbidität und Mortalität muss eine frühe Diagnosestellung und adäquate Therapie angestrebt werden. Nicht selten führen jedoch die unspezifische Symptomatik des OHS und die oftmals komorbiden schlafmedizinischen, metabolischen und kardiovaskulären Erkrankungen dazu, dass das OHS nicht oder erst verzögert diagnostiziert wird. Daher ist in der Risikoklientel die gezielte Suche nach dem Vorliegen einer Hyperkapnie im Wachzustand indiziert.

Summary

While obesity is associated with numerous cardiovascular and metabolic diseases, obesity hypoventilation syndrome (OHS) is one of the major diseases affecting the respiratory system. OHS is defined by chronic daytime hypercapnia (carbon dioxide partial pressure chronically elevated ≥45 mmHg) in the presence of a body mass index ≥30 kg/m². Before establishing the diagnosis of OHS, other reasons for alveolar hypoventilation have to be excluded. The pathophysiology of OHS includes reductions of lung function, impaired central ventilatory drive and sleep-related breathing disorders. Early diagnosis and initiation of an adequate therapy is crucial concerning the burden of morbidity and mortality associated with OHS. Identification of OHS is missed or delayed frequently, due to unspecific symptoms and comorbid sleep-related, cardiovascular and metabolic diseases. To improve identification of OHS patients, a systematic search for daytime hypercapnia is essential in patients at risk.

Schlüsselwörter

Obesitas-Hypoventilationssyndrom - Adipositas - Hyperkapnie - Pathophysiologie

Keywords

Obesity hypoventilation syndrome - obesity - hypercapnia - pathophysiology

Full Text

References

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