Obesity Hypoventilation (Pickwickian) Syndrome – ”The Tip of an Iceberg” in Morbidly Obese Patients

• DOI: 10.4103/mjdrdypu.mjdrdypu_670_23
• Publication Date: 2024-09-18T11:00:40Z
• Authors: Arun Balan; Sachinkumar S. Dole
• Keywords: Morbidly obese; Obesity hypoventilation syndrome; Iceberg

A BSTRACT Obesity hypoventilation syndrome (OHS), also known as Pickwickian syndrome, is a combination of obesity (body mass index (BMI) >30 kg/m 2 ), daytime hypercapnia (arterial carbon dioxide tension >45 mm Hg) and sleep-disordered breathing, after exclusion other disorders that may cause alveolar hypoventilation. Management OHS requires multifaceted approach in the form weight loss, treatment existing co-illnesses, pulmonary rehabilitation, Bi-level positive airway pressure (Bi-PAP) therapy. 58-year-old lady with BMI 50 symptoms obstructive sleep apnea (OSA) presented to hospital respiratory distress. She gave history breathlessness, snoring, disturbances for last 7 years. was managed by physician diagnosis disease without further evaluation disturbance. On admission, she started on non-invasive ventilation during her initial management. After 72 hours patient became stable, overnight polysomnography performed confirm OHS. confirmation diagnosis, Bi-PAP therapy along supportive days. discharged 10 days admission nocturnal at home enrolled comprehensive rehabilitation program. Patient regular follow-up has been doing well since then.