ʻO Obesity hypoventilation Syndrome (OHS)

ʻO ka Obesity hypoventilation Syndrome (OHS) kahi kūlana i loko o kekahi poʻe momona i kahi hanu maikaʻi ʻole e alakaʻi ai i ka oxygen haʻahaʻa a me nā kiʻekiʻe o ke kalapona kalapona i ke koko.

ʻAʻole ʻike ʻia ke kumu kūpono o OHS. Manaʻo nā kānaka noiʻi OHS nā hopena mai kahi hemahema i ka kaohi o ka lolo i ka hanu ʻana. ʻO ka nui o ke kaupaona ʻana i ka paia o ka umauma ka mea e paʻakikī ai ka huki ʻana o nāʻiʻo i ka hanu hohonu a me ka hanu wikiwiki ʻana. Hoʻonui kēia i ka ka hanu ʻana o ka lolo. A ʻo kahi hopena, loaʻa i ke koko ka nui o carbon dioxide a ʻaʻole lawa ka oxygen.

ʻO nā ʻōuli nui o OHS ma muli o ka hiamoe ʻole a hoʻokomo pū ʻia:

• Maikaʻi maikaʻi ʻole ka hiamoe
• ʻAlena moe
• Ka hiamoe o ke ao
• Kaumaha
• Poʻo poʻo poʻo
• Ka luhi

ʻO nā ʻōuli o ke kiʻekiʻe o ka oxygen oxygen (hypoxia mau) hiki pū kekahi. Pākuʻi ʻia nā ʻōuli me ka hanu ʻana a me ka luhi paha ma hope o ka hana iki.

ʻO ka poʻe me OHS ke kaupaona nui loa. Hōʻike kahi hoʻokolohua kino:

• ʻO kaʻulaʻula Bluish i nā lehelehe, nā manamana lima, nā manamana wāwae, a me ka ʻili (cyanosis)
• ʻIli ʻulaʻula
• Nā ʻōuli o ke kīnā ʻole o ka puʻuwai ʻaoʻao ʻākau (cor pulmonale), e like me nā wāwae a me nā wāwae i pehu, ka hanu ʻana, a me ka luhi paha ma hope o ka hana iki.
• Nā hōʻailona o ka nui hiamoe

Hoʻohana ʻia nā hoʻokolohua e kōkua i ke kuhi a hōʻoia i ka OHS:

• Ke kinoea koko arterial
• Pākuʻi x-ray a i ʻole CT scan e kāpae i nā kumu kūpono ʻē aʻe
• Nā hoʻāʻo hana lung (nā hoʻāʻo o ka hana pulmonary)
• ʻImi hiamoe (polysomnography)
• Echocardiogram (ultrasound o ka puʻuwai)

Hiki i nā mea lawelawe olakino ke haʻi aku iā OHS mai ka papa hiamoe ākea no ka mea he kanaka me OHS kahi kiʻekiʻe o ke kalapona kalapona i loko o ko lākou koko ke ala aʻe.

Hoʻopili ka hana me ke kōkua ʻana i ka hanu ʻana me ka hoʻohana ʻana i nā mīkini kūikawā (ʻenekini mīkini). Nā koho ʻē aʻe:

• Noninvasive mechanical ventilation e like me ka hoʻomau ʻana o ke ea airway pressure (CPAP) a i ʻole ka bilevel positive airway pressure (BiPAP) ma o kahi mask e pili pono ana ma ka ihu a me ka ihu a me ka waha (ʻo ka mea nui no ka hiamoe)
• ʻOkoʻa oxygen
• Kōkua hanu ma o ka wehe ʻana i ka ʻāʻī (tracheostomy) no nā hihia koʻikoʻi

Hoʻomaka ka lapaʻau ʻana ma ka haukapila a i ʻole ma ke ʻano he mea maʻi.

Hoʻonohonoho ʻia nā hana ʻē aʻe i ka pohō kaumaha, hiki ke hoʻohuli iā OHS.

Mālama ʻole ʻia, hiki i ka OHS ke alakaʻi i nā pilikia o ka puʻuwai a me nā kīʻaha koko, ke kīnā koʻikoʻi, a i ʻole ka make.

Hiki i nā pilikia OHS e pili ana i ka nele o ka hiamoe.

• Kaumaha, hoʻonāukiuki, huhū
• Hoʻonui i ka makaʻu no nā ulia a me nā hewa i ka hana
• Nā pilikia me ka pilina a me ka moekolohe

Hiki i ke OHS ke hoʻopilikia i ka naʻau, e like me:

• Ke koko kiʻekiʻe (hypertension)
• Hoka puʻuwai ʻaoʻao ʻākau (cor pulmonale)
• ʻO ke koko kiʻekiʻe i loko o nā māmā (hypertension pulmonary)

Kāhea i kāu mea hāʻawi inā luhi nui ʻoe i ke ao a i ʻole nā ​​hōʻailona ʻē aʻe e hōʻike iā OHS.

Mālama i kahi kaupaona olakino a pale i ka momona. E hoʻohana i kāu CPAP a i ʻole BiPAP lapaʻau e like me ka mea i kauoha ʻia e kāu mea hāʻawi.

ʻO Pickwickian Syndrome

• ʻŌnaehana hanu

Malhotra A, Powell F. Nā maʻi o ka hoʻokele ea. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 80.

Mokhlesi B. Synes-hypoventilation maʻi maʻi. I: Kryger M, Roth T, Dement WC, hua pā. Nā Kumumanaʻo a me ka Hoʻomaʻamaʻa ʻana o ka lāʻau hiamoe. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2017: chap 120.

Mokhlesi B, Masa JF, Brozek JL, et al. Ka loiloi a me ka hoʻokele o ka obesity hypoventilation syndrome. He kulekele hana lāʻau lapaʻau American Thoracic Society. ʻO Am J Respir Crit Care Med. 2019; 200 (3): e6-e24. PMID: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798.