PICKWICKIAN SYNDROME

Course overview

OBESITY HYPOVENTILATION SYNDROME (OHS OR PICKWICKIAN SYNDROME) IS DEFINED AS THE PRESENCE OF AWAKE ALVEOLAR HYPOVENTILATION CHARACTERIZED BY DAYTIME HYPERCAPNIA (ARTERIAL PACO2 GREATER THAN 45 MMHG [5.9 KPA]) THAT IS THOUGHT TO BE A CONSEQUENCE OF DIMINISHED VENTILATORY DRIVE AND CAPACITY RELATED TO OBESITY (BMI OVER 30 KG/M^2) IN THE ABSENCE OF AN ALTERNATE RESPIRATORY, NEUROMUSCULAR, OR METABOLIC EXPLANATION FOR HYPOVENTILATION. THE MANAGEMENT OF PICKWICKIAN SYNDROME IS CHALLENGING AND COMPLEX, AND THE CLINICAL PRESENTATION OF THE DISEASE SHOULD BE SUSPECTED EARLY TO ACHIEVE GOOD OUTCOMES. THIS ACTIVITY REVIEWS THE EPIDEMIOLOGY, ETIOPATHOGENESIS, CLINICAL FEATURES, MANAGEMENT, AND PROGNOSIS AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR PATIENTS WITH THIS CONDITION.