The American Journal of Medicine
Volume 59, Issue 3 , Pages 343-348, September 1975

Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome☆

  • Clifford W. Zwillich, M.D.

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Dr. Clifford W. Zwillich, Pulmonary Division, Department of Medicine, University of Colorado Medical Center, 4200 East Ninth Avenue, Denver, Colorado 80220.
    • From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.
    • ,
  • Frank D. Sutton, M.D.

      Affiliations

    • From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.
    • Present address: Mercy Hospital, Birmingham, Alabama.
    • ,
  • David J. Pierson, M.D.

      Affiliations

    • From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.
    • Present address: U.S. Army Medical Corps, Bremen, Germany.
    • ,
  • Edward M. Creagh, M.D.

      Affiliations

    • From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.
    • Present address: U.S. Army Medical Corps, Bremen, Germany.
    • ,
  • John V. Weil, M.D.

      Affiliations

    • From the Cardiovascular Pulmonary Research Laboratory and Pulmonary Division of the Department of Medicine, University of Colorado Medical Center, Denver, Colorado.
    • Recipient of Research Career Development Award.

Denver, Colorado USA

Accepted 22 January 1975.

Abstract 

Most patients with extreme obesity do not exhibit alveolar hypoventilation, but an intriguing minority do. The mechanism(s) of this phenomenon remain unknown. A disorder in ventilatory control has been suggested as a major factor in the pathogenesis of the obesity-hypoventilation syndrome. Accordingly, hypoxic and hypercapnic ventilatory drives were measured in 10 patients with the typical symptoms of the syndrome: obesity, hypersomnolence, hypercapnia, hypoxemla, polycythemia and cor pulmonale. Hypoxic ventilatory drive, measured as the shape parameter A, averaged 21.9 ± 5.35, approximately one-sixth that in normal controls, A = 126 ± 8.6 (P < 0.01). The ventilatory response to hypercapnia also was markedly reduced, the slope of the response averaging 0.51 ± 0.005, or about one-third the normal value of 1.83 ± 0.13 (P < 0.01). This decreased responsiveness in hypoxic and hypercapnic ventilatory drive was consistent throughout the group. The depression in ventilatory drive found in the obesity-hypoventilatlon syndrome may be causally related to the alveolar hypoventilation manifested by these patients.

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☆ This study was supported by National Institutes of Health Program Project Grant HL-14985-03 and Intensive Respiratory Care and Rehabilitation Grant HL-04933, Bethesda, Maryland.

PII: 0002-9343(75)90392-7

The American Journal of Medicine
Volume 59, Issue 3 , Pages 343-348, September 1975

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