The Egyptian Journal of Bronchology (Jan 2017)
Study of the value of percutaneous nocturnal oximetry in the monitoring of obese hypoventilation syndrome patients under non invasive home ventilation
Abstract
Abstract Background Nocturnal noninvasive ventilation (NIV) is often a treatment option for obesity hypoventilation syndrome (OHS). Monitoring this treatment is important to verify its efficacy. Aim The aim of the present study was to assess the role of overnight pulse oximetry in the monitoring of OHS patients under NIV. Patients and methods Twenty patients with OHS using nocturnal bilevel positive airway pressure therapy without supplemental oxygen were included in the present study. Overnight pulse oximetry study was performed, and according to the results, the patients were divided into two groups: group I (normal study) and group II [abnormal study showing nocturnal percutaneous oxygen saturation (SpO2) <90% in ≥10% of the total recorded time]. Group II patients were subjected to respiratory polygraphy for more detailed assessment, and then, appropriate therapeutic modifications were done, after which a second overnight pulse oximetry study was performed to verify the efficacy of ventilation after these modifications. Results Twenty OHS patients using nocturnal NIV were included in the present study. There were eight (40%) male patients and 12 (60%) female patients, with a mean age of 58.7±7.39 years. The mean BMI was 45.86±3.71 kg/m2. Group I consisted of 11 (55%) patients and group II had nine (45%) patients. Respiratory polygraphy performed to group II detected airway obstruction in two patients, insufficient ventilation in five patients and significant nonintentional leaks in two patients. Therapeutic modifications were done, and then a second overnight pulse oximetry performed showing normal results in seven patients, whereas two patients showed lesser desaturations but results were still abnormal. Conclusion Overnight pulse oximetry is a very useful tool in assessment of NIV efficacy in OHS patients, it is portable, simple, and it can detect oxygen desaturations that direct to perform further tests to apply appropriate therapeutic modifications to optimize NIV.
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