PLoS ONE (Jan 2014)

Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure.

  • Malcolm Lemyze,
  • Pauline Taufour,
  • Alain Duhamel,
  • Johanna Temime,
  • Olivier Nigeon,
  • Nicolas Vangrunderbeeck,
  • Stéphanie Barrailler,
  • Gaëlle Gasan,
  • Florent Pepy,
  • Didier Thevenin,
  • Jihad Mallat

DOI
https://doi.org/10.1371/journal.pone.0097563
Journal volume & issue
Vol. 9, no. 5
p. e97563

Abstract

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PurposeAcute respiratory failure (ARF) is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS). We aimed to identify the determinants of noninvasive ventilation (NIV) success or failure for this indication.MethodsWe prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-bed ICU of a tertiary hospital.ResultsNIV failed to reverse ARF in only 13 patients. Factors associated with NIV failure included pneumonia (n = 12/13, 92% vs n = 9/63, 14%; pConclusionsMultiple organ failure and pneumonia were the main factors associated with NIV failure and death in morbidly obese patients in hypoxemic ARF. On the opposite, NIV was constantly successful and could be safely pushed further in case of severe hypercapnic acute respiratory decompensation of OHS.