Hypoventilation

About: Hypoventilation is a research topic. Over the lifetime, 1772 publications have been published within this topic receiving 40799 citations. The topic is also known as: respiratory depression.

Complicações respiratórias pós-operatórias em cirurgia bariátrica: revisão da literatura

Abstract: Obesity is a public health problem worldwide because of the high rates of morbimortality. Bariatric surgery has been the most often treatment and attracts attention on its development and results. However, there is no review about the incidence of respiratory complications in this population. The aim of this study was to review the literature on respiratory complications in conventional bariatric surgery utilizing the databases PubMed, Scielo and Cochrane. The terms searched were complications, pulmonary, postoperative care and bariatric surgery, and the limits, the last ten years, adults, English and Spanish. We found 69 articles, and used 21, showing that the most common respiratory complications in bariatric surgery are pulmonary embolism, atelectasis and pneumonia, being related to age and the presence of hypoventilation. Morbid obesity is associated with respiratory dysfunction, including decreased cardiorespiratory endurance and dyspnea, being the most common changes: the decrease in ventilation and chest wall compliance, and tachypnea and respiratory muscle workload, with high rates of hypoxemia and respiratory fatigue. Our results suggest that pulmonary embolism, atelectasis and pneumonia are the pulmonary complications with the highest incidences in conventional bariatric surgery, and elderly and patients with hypoventilation or syndrome and obstructive sleep apnea have higher risk of developing postoperative pulmonary complications.

Emergency Diagnosis of Opioid Intoxication

Abstract: Opioids are widely used for analgesic purposes. If taken as prescribed, they are safe and effective. Overdosing, however, can cause coma and life-threatening respiratory depression. In the acute care setting, physicians often base treatment on the presence of classic “opioid syndrome” characteristics—mental status depression, hypoventilation, miosis (pinpoint pupils), and reduced bowel motility. Rather than identify and quantify the specific agent, laboratories should confirm opioid intoxication qualitatively with a urine drug screen. With this information, physicians may expedite treatment with opioid antagonists (naloxone), which help patients to resume spontaneous respiration. Because the drug level does not always correlate with the severity of illness, quantitative drug levels are rarely needed. Hypoglycemia, hypoxia, and hypothermia are also seen with opioid overdose.

The Malignant Obesity Hypoventilation Syndrome (MOHS)

Abstract: Malignant obesity hypoventilation syndrome (MOHS) is a severe multisystem disease due to effects of obesity. MOHS is associated with increased healthcare utilization and a high risk of mortality. This syndrome is largely unrecognized because providers usually do not associate the patients’ multiple medical problems and obesity. Subjects with this syndrome have severe obesity-related hypoventilation along with systemic hypertension, diabetes and metabolic syndrome, left ventricular hypertrophy with diastolic dysfunction, pulmonary hypertension, and hepatic dysfunction. MOHS should be suspected in any obese patient presenting with acute respiratory failure. Management of this condition includes short-term measures (correcting the acute hypercapnia and treatment of triggers of acute decompensating episode) and long-term measures (directed toward weight loss, maintenance therapy with noninvasive ventilation, and management of comorbidities). Due to its proven benefits reversing the multiple metabolic and organ dysfunctions associated with MOHS, bariatric surgery should always be considered in this condition.