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Therapeutic use of progesterone in alveolar hypoventilation associated with obesity

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      Abstract

      A study was made of eight very obese patients, average body weight 325 pounds, with the alveolar hypoventilation syndrome. Initial treatment included a low calorie intake, the administration of digitalis and diuretics, and intermittent positive pressure breathing. After a stable level of improvement was reached, within five to twenty-three days, 100 mg. of progesterone was given daily by intramuscular injection. Progesterone therapy increased alveolar ventilation by an additional 29.3 per cent and total minute ventilation by 20.6 per cent. Arterial blood gas tensions and pH were returned toward normal and respiratory acidosis was abolished. Abnormal ventilatory-carbon dioxide response curves were restored to normal by progesterone therapy. Progesterone is thus an effective agent for improving ventilation in patients with the obesity-hypoventilation syndrome. The site and mode of action of progesterone is unknown. Respiratory control was normal during progesterone administration, but reappearance of an abnormal state recurred within a month after progesterone therapy was discontinued.
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