Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An obese patient with a ten year history of respiratory failure presented with insomnia and marked daytime somnolence. Respriatory failure had been attributed to obesity, respiratory centre insensitivity to carbon dioxide, and to diffuse airways obstruction. To investigate the possible role of episodic apnoea with frequent nocturnal arousals, continous recordings were obtained during sleep of arterial oxygen saturation, oesophageal pressure and the motions of the rib-cage and abdomen/diaphragm. Repeated episodes of hypoventilation and profound hypoxaemia were found which were due to intermittent obstruction of the upper airway rather than to cessation of breathing efforts. During the episodes of hypoxaemia, values of arterial O2 tension fell to as low as 24 mmHg. Episodic hypoxaemia was relieved but not abolished, by the use of a collar, designed to hold the mandible forward. Previous reports indicated that recognition of intermittent obstruction of the upper airway during sleep and treatment by a permanent tracheostomy, resulted in a significant long-term imporvement of pulmonary and cardiac function and relief of insomnia and day-time somnolence. When tracheostomy is inadvisable, as in the present patient, it is hoped that similar long-term benefits will result from a supportive collar.
 ...
PMID:Intemittent obstruction of the upper airway during sleep causing profound hypoxaemia. A neglected mechanism exacerbating chronic respiratory failure. 107 82

Respiratory events are between the most frequent postoperative complications. The preoperative conditions associated with postoperative respiratory failure were evaluated in a prospective study of 1182 patients from six Italian Surgical Units. Multiple regression logistic analysis was employed for statistical evaluation and a predictive prognostic score was derived. Only the presence of the following conditions was significant in affecting postoperative respiratory outcomes: preoperative respiratory and cardiac failure, hypotransferrinemia, prolonged surgical procedures (above the 2 hours) and peroperative bacterial contamination. Advanced age did not appear as a major risk factor. Studies on the predetermination of the pulmonary complications have been widely published. Historical risk factors include the presence of respiratory disease, smoking habits, obesity and thoracic or upper abdominal surgical procedures. Although the results of the present study need a prospective confirmation, the predictive scoring system proves to be a usefull tool that can be employed in most of the General Surgery Units.
 ...
PMID:[Multifactorial surgical risk index of the development of respiratory complications]. 146 55

The purpose of this study was to assess the efficacy of bi-level positive airway pressure (BiPAP) ventilation through a nasal mask in the treatment of eight patients with hypoventilatory respiratory failure and nocturnal CO2 retention. Nocturnal CO2 retention was significantly reduced in all patients with the application of BiPAP during sleep (p less than 0.01). Daytime somnolence was relieved and dyspnea improved after three months of home BiPAP therapy. All patients tolerated home BiPAP therapy, and two patients who had previously been treated with volume ventilation via nasal mask found BiPAP more comfortable. There were no changes in FEV1 or FVC after three months of BiPAP. Daytime PaCO2 improved slightly or remained stable in all patients after three months of home BiPAP. BiPAP nasal ventilation is effective in reducing nocturnal CO2 retention short term in hypoventilatory respiratory failure due to obesity hypoventilation syndrome, chest wall restriction, or neuromuscular disease. Further studies in patients with COPD may be warranted.
 ...
PMID:Nocturnal nasal intermittent positive pressure ventilation with bi-level positive airway pressure (BiPAP) in respiratory failure. 173 82

In order to determine whether the presence of obesity, defined as increased body mass index, would serve as a predictor of severity in acute pancreatitis, we have reviewed the medical records of 27 patients with severe acute pancreatitis. All patients had at least four positive Ranson's signs; all but three patients had at least five Ranson's signs. When the 13 patients with a fatal outcome were compared with the 14 who lived, neither obesity nor respiratory failure was an independent predictor of death. However, when the 27 patients were analyzed on the basis of whether they were obese (15 patients) or not obese (12 patients), obesity was an independent predictor of respiratory failure. Obesity was not a predictor of renal failure, pancreatic necrosis, or need for surgery. We suggest that obese patients with severe acute pancreatitis require close monitoring for the development of respiratory failure.
 ...
PMID:Obesity as a predictor of severity in acute pancreatitis. 178 36

Intermittent mechanical ventilation via nasal CPAP mask was provided to 13 patients admitted to this institution for exacerbation of chronic respiratory failure. Ten suffered from COPD, two suffered from obesity hypoventilation syndrome (OHS), and one from severe hypothyroidism. All except one presented with dyspnea and hypercapnia due solely to progression of their underlying disease processes. Six of the patients with COPD and the patient with hypothyroidism responded to positive pressure ventilation by mask with improvements in blood gas values and clinical status. The remaining two patients with COPD and the two patients with OHS were unable to use the system. Four of the patients with COPD and chronic respiratory failure have been subsequently maintained on daily volume ventilation via nasal mask for about 20 months with persistent clinical and physiologic improvements. Application of volume ventilation through the nasal CPAP mask is a feasible strategy for providing long-term mechanical ventilation to selected patients with COPD and respiratory failure.
 ...
PMID:Intermittent volume cycled mechanical ventilation via nasal mask in patients with respiratory failure due to COPD. 155 51

An obese woman with respiratory failure and bilateral diaphragmatic paralysis, was studied in order to investigate the effects of weight loss on respiratory function during wakefulness and sleep. The patient was studied on 5 different occasions during which diurnal blood gas analysis, spirometry, CO2 rebreathing test, nitrogen wash-out test and a nocturnal polysomnographic study were performed. The follow-up period lasted 9 months, during which the patient progressively lost 19 kg. Progressive improvement in awake blood gas tensions (PaO2 + 21 mmHg, PaCO2 - 16 mmHg) as well as in nocturnal oxyhemoglobin saturation and transcutaneous PCO2 were observed; at the same time only minor changes in responsiveness to CO2 and in lung volumes were found. Conversely alveolar efficiency for CO2, obtained with the nitrogen wash-out test, in the supine posture increased from 81.7 to 90.5%, indicating an improvement in ventilation/perfusion ratio as a possible determinant of blood gas tension improvement during wakefulness and, as a consequence, also during sleep. We conclude that obesity is one possible cause of the occurrence of respiratory failure in bilateral diaphragmatic paralysis.
 ...
PMID:Obesity as a possible cause of respiratory failure in bilateral diaphragmatic paralysis. Case report. 248 95

Non-apnoeic oxygen desaturation related to rapid eye movement (REM) sleep in a patient with hypothyroidism, obesity, respiratory failure, and cardiac failure was improved by treatment with nasal continuous positive airway pressure of 10 cm H2O.
 ...
PMID:Non-apnoeic REM sleep induced nocturnal oxygen desaturation treated by nasal continuous positive airway pressure. 266 26

A case is reported of acute respiratory failure occurring during upper abdominal surgery in a patient not previously known to have chronic respiratory failure. Preoperatively, this 68 year old patient presented with mild obesity, slight effort dyspnoea and paralysis of the right hemidiaphragm, a sequela of polytrauma she suffered the year before. Respiratory tests were not considered useful with regard to the results of clinical examination. Moreover, she had already several previous general anaesthetics without any problems. A thoracic epidural anaesthesia was performed with a mixture of 150 mg lidocaine, 37.5 mg bupivacaine with adrenaline and 100 micrograms fentanyl, injected in the T8-T9 epidural space via a catheter. Ten minutes after the starting of surgery, the patient became agitated and complained of difficulty in breathing. Blood gas analysis showed hypercapnia, with respiratory acidosis (Pao2: 28.19 kPa; Paco2: 9.2 kPa; pH 7.273). Clinical examination revealed a bilateral Horner syndrome (T1-T4 sympathetic blockade). The patient was intubated and ventilated after adequate sedation. She was extubated 3 h 30 min after the initial epidural injection. Epidural analgesia was maintained during 72 h, with 0.1% bupivacaine, with no recurrence of respiratory failure.
 ...
PMID:[Transient acute respiratory failure and thoracic epidural anesthesia]. 273 73

In December 1986 a 30-month-old female child with morbid obesity and respiratory failure was admitted to the Izaak Walton Killam Hospital for Children in Halifax. The etiology of the obesity was found to be dietary in origin after ruling out genetic, neurological and metabolic causes. This patient exhibited somnolence and cyanosis in association with hypercapnia and right ventricular overload. Her respiratory failure in the presence of a normal upper airway required ventilatory support, first with nasal endotracheal intubation, and then, tracheotomy. Weight reduction normalized her capillary blood gases and her somnolence disappeared. Subglottic stenosis hampered removal of the tracheotomy tube until 9 months after admission. The pathogenesis and management of obese hypoventilation syndrome are reviewed by the authors.
 ...
PMID:Obese hypoventilation syndrome of early childhood requiring ventilatory support. 306 Apr 36

DIAPHRAGM ACTIVITY DURING CARBON DIOXIDE BREATHING AND TOTAL CHEST COMPLIANCE DURING DIAPHRAGM RELAXATION WERE MEASURED IN EIGHT OBESE SUBJECTS: four with normal blood gases and four with hypercapnia and hypoxemia. Whereas there were no significant differences in the values of total chest compliance between the two groups, there were marked differences in diaphragm activity. The increase in integrated electrical activity in the diaphragm, per millimeter increment in carbon dioxide tension in the arterial blood, averaged 66 units (range: 48-90) in the obese-normal subjects and 17 units (range: 12-22) in the obese-hypoventilation subjects. These results suggest that an incapacity to increase the activity in the respiratory muscles, to levels necessary to overcome the load caused by obesity, plays a major role in the genesis of respiratory failure in obese subjects.
 ...
PMID:Diaphragm activity in obesity. 582 73


1 2 3 4 5 6 7 8 9 10 Next >>