Mechanisms of Disease – From the Masters #2 Obesity Hypoventilation Syndrome

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.

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