A 55-year-old woman with diabetes, hypertension, obesity (BMI 45 kg/m2), and obesity hypoventilation/obstructive sleep apnea (OHS/OSA) presented to an Emergency Department with dyspnea and somnolence of 2 days duration. Arterial blood, sampled while she breathed 50% oxygen via face mask at a rate of 22 breaths per minute, revealed a pH 7.26; PCO2 80 mmHg; PO2 150 mmHg ; [HCO3] 35mEq/l; BEecf 8.3 mEq/l. She was intubated for hypercapnic respiratory failure and admitted to the intensive care unit.
Questions regarding the pathophysiology and hospital-based management of obesity hypoventilation syndrome addressed by Drs. Roberta Goldring, Kenneth Berger and Beno Oppenheimer at New York University School of Medicine.