Non-invasive ventilation in super obese young patients: a case report

1. Masa JF, Pépin JL, Borel JC, Mokhlesi B, Murphy PB, Sánchez-Quiroga MÁ. Obesity hypoventilation syndrome. European Respiratory Review. 2019;28: 180097. doi:10.1183/16000617.0097-2018 Masa JF Pépin JL Borel JC Mokhlesi B Murphy PB Sánchez-Quiroga MÁ. Obesity hypoventilation syndrome . European Respiratory Review . 2019 ; 28 : 180097 . 10.1183/16000617.0097-2018 Open DOISearch in Google Scholar

2. Shah NM, Shrimanker S, Kaltsakas G. Defining obesity hypoventilation syndrome. Breathe (Sheffield, England). 2021;17(3): 210089. doi:10.1183/20734735.0089-2021 Shah NM Shrimanker S Kaltsakas G. Defining obesity hypoventilation syndrome . Breathe (Sheffield, England) . 2021 ; 17 ( 3 ): 210089 . 10.1183/20734735.0089-2021 Open DOISearch in Google Scholar

3. Orozco González BN, Rodriguez Plascencia N, Palma Zapata JA, Llamas Domínguez AE, Rodríguez González JS, Diaz JM, et al. Obesity hypoventilation syndrome, literature review. Sleep Advances. 2024;5(1): zpae033. doi:10.1093/sleepadvances/zpae033 Orozco González BN Rodriguez Plascencia N Palma Zapata JA Llamas Domínguez AE Rodríguez González JS Diaz JM Obesity hypoventilation syndrome, literature review . Sleep Advances . 2024 ; 5 ( 1 ): zpae033 . 10.1093/sleepadvances/zpae033 Open DOISearch in Google Scholar

4. GBD 2019 Risk Factor Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England). 2020;396: 1223–1249. doi:10.1016/S0140-6736(20)30752-2 GBD 2019 Risk Factor Collaborators . Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 . Lancet (London, England) . 2020 ; 396 : 1223 – 1249 . 10.1016/S0140-6736(20)30752-2 Open DOISearch in Google Scholar

5. Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health. 2022 Sep;7(9):e009773. doi: 10.1136/bmjgh-2022-009773. PMID: 36130777; PMCID: PMC9494015. Okunogbe A Nugent R Spencer G Powis J Ralston J Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries . BMJ Glob Health . 2022 Sep ; 7 ( 9 ): e009773 . 10.1136/bmjgh-2022-009773 . 36130777 ; PMC9494015 . Open DOISearch in Google Scholar

6. Hruby A, Manson JE, Qi L, Malik VS, Rimm EB, Sun Q, et al. Determinants and consequences of obesity. American Journal of Public Health. 2016;106: 1656–1662. doi:10.2105/AJPH.2016.303326 Hruby A Manson JE Qi L Malik VS Rimm EB Sun Q Determinants and consequences of obesity . American Journal of Public Health . 2016 ; 106 : 1656 – 1662 . 10.2105/AJPH.2016.303326 Open DOISearch in Google Scholar

7. Maxim M, Soroceanu RP, Vlăsceanu VI, Platon RL, Toader M, Miler AA, Onofriescu A, Abdulan IM, Ciuntu B-M, Balan G, et al. Dietary Habits, Obesity, and Bariatric Surgery: A Review of Impact and Interventions. Nutrients 2025;17: 474. https://doi. org/10.3390/nu17030474 Maxim M Soroceanu RP Vlăsceanu VI Platon RL Toader M Miler AA Onofriescu A Abdulan IM Ciuntu B-M Balan G Dietary Habits, Obesity, and Bariatric Surgery: A Review of Impact and Interventions . Nutrients 2025 ; 17 : 474 . https://doi.org/10.3390/nu17030474 Search in Google Scholar

8. Copăescu C. The Romanian Society for Metabolic Surgery and KANTAR Romania, obesity incidence in the Romanian population (RO-OS 2024). World Obesity Federation, World Obesity Atlas 2023; 2024. https://www.rsms.ro/obesity-incidence-in-the-romanian-population-ro-os-2024/ Copăescu C. The Romanian Society for Metabolic Surgery and KANTAR Romania, obesity incidence in the Romanian population (RO-OS 2024) . World Obesity Federation, World Obesity Atlas 2023 ; 2024 . https://www.rsms.ro/obesity-incidence-in-the-romanian-population-ro-os-2024/ Search in Google Scholar

9. Ghimire P, Sankari A, Antoine MH, et al. Obesity-Hypoventilation Syndrome. [Updated 2025 Jun 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542216/ Ghimire P Sankari A Antoine MH Obesity-Hypoventilation Syndrome. [Updated 2025 Jun 30] . In: StatPearls [Internet] . Treasure Island (FL) : StatPearls Publishing ; 2025 Jan -. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542216/ Search in Google Scholar

10. Balachandran JS, Masa JF, Mokhlesi B. Obesity hypoventilation syndrome epidemiology and diagnosis. Sleep Medicine Clinics. 2014;9(3): 341–347. doi:10.1016/j.jsmc.2014.05.007 Balachandran JS Masa JF Mokhlesi B. Obesity hypoventilation syndrome epidemiology and diagnosis . Sleep Medicine Clinics . 2014 ; 9 ( 3 ): 341 – 347 . 10.1016/j.jsmc.2014.05.007 Open DOISearch in Google Scholar

11. Brandon Peters MD. Treatment of obesity hypoventilation syndrome. 2023. Brandon Peters MD. Treatment of obesity hypoventilation syndrome . 2023 . Search in Google Scholar

12. Ramírez Molina VR, Masa Jiménez JF, Gómez de Terreros Caro FJ, Corral Peñafiel J. Effectiveness of different treatments in obesity hypoventilation syndrome. Pulmonology. 2020;26(6): 370–377. doi:10.1016/j.pulmoe.2020.05.012 Ramírez Molina VR Masa Jiménez JF Gómez de Terreros Caro FJ Corral Peñafiel J. Effectiveness of different treatments in obesity hypoventilation syndrome . Pulmonology . 2020 ; 26 ( 6 ): 370 – 377 . 10.1016/j.pulmoe.2020.05.012 Open DOISearch in Google Scholar

13. Couillard A, Pepin J-L, Rabec C, Cuvelier A, Portmann A, Muir J-F. Noninvasive ventilation: efficacy of a new ventilatory mode in patients with obesity-hypoventilation syndrome. Revue des Maladies Respiratoires. 2015;32(3): 283–290. doi:10.1016/j. rmr.2014.02.013 Couillard A Pepin J-L Rabec C Cuvelier A Portmann A Muir J-F. Noninvasive ventilation: efficacy of a new ventilatory mode in patients with obesity-hypoventilation syndrome . Revue des Maladies Respiratoires . 2015 ; 32 ( 3 ): 283 – 290 . 10.1016/j.rmr.2014.02.013 Open DOISearch in Google Scholar

14. Yarrarapu SNS, Saunders H, Sanghavi DK. Average Volume-Assured Pressure Support. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560600/. . Yarrarapu SNS Saunders H Sanghavi DK. Average Volume-Assured Pressure Support. [Updated 2023 Aug 8] . In: StatPearls [Internet] . Treasure Island (FL) : StatPearls Publishing ; 2025 Jan -. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560600/ . . Search in Google Scholar

15. Patout M, Gagnadoux F, Rabec C, Trzepizur W, Georges M, Perrin C, et al. AVAPS-AE versus ST mode: a randomized controlled trial in patients with obesity hypoventilation syndrome. Respirology (Carlton, Vic.). 2020;25(10): 1073–1081. doi:10.1111/resp.13784 Patout M Gagnadoux F Rabec C Trzepizur W Georges M Perrin C AVAPS-AE versus ST mode: a randomized controlled trial in patients with obesity hypoventilation syndrome . Respirology (Carlton, Vic.) . 2020 ; 25 ( 10 ): 1073 – 1081 . 10.1111/resp.13784 Open DOISearch in Google Scholar

16. Aloud A. Average volume-assured pressure support. The Southwest Respiratory and Critical Care Chronicles. 2018. https://doi.org/10.12746/swrccc.v6i22.438 Aloud A. Average volume-assured pressure support . The Southwest Respiratory and Critical Care Chronicles . 2018 . https://doi.org/10.12746/swrccc.v6i22.438 Search in Google Scholar

17. Gören NZ, Şancı E, Ercan Coşkun FF, Gürsoylu D, Bayram B. Comparison of BPAP S/T and average volume-assured pressure support modes for hypercapnic respiratory failure in the emergency department: a randomized controlled trial. Balkan Medical Journal. 2021;38: 265–271. doi:10.5152/balkanmedj.2021.20137 Gören NZ Şancı E Ercan Coşkun FF Gürsoylu D Bayram B. Comparison of BPAP S/T and average volume-assured pressure support modes for hypercapnic respiratory failure in the emergency department: a randomized controlled trial . Balkan Medical Journal . 2021 ; 38 : 265 – 271 . 10.5152/balkanmedj.2021.20137 Open DOISearch in Google Scholar

18. Mokhlesi B, Masa JF, Brozek JL, Gurubhagavatula I, Murphy PB, Piper AJ, et al. Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society Clinical Practice Guideline. American Journal of Respiratory and Critical Care Medicine. 2019;200(3): e6–e24.Erratum in: American Journal of Respiratory and Critical Care Medicine. 2019 Nov 15;200(10):1326. doi: 10.1164/rccm.v200erratum7. doi:10.1164/rccm.201905-1071ST Mokhlesi B Masa JF Brozek JL Gurubhagavatula I Murphy PB Piper AJ Evaluation and management of obesity hypoventilation syndrome. An official American Thoracic Society Clinical Practice Guideline . American Journal of Respiratory and Critical Care Medicine. 2019;200(3): e6–e24.Erratum in: American Journal of Respiratory and Critical Care Medicine . 2019 Nov 15 ; 200 ( 10 ): 1326 . 10.1164/rccm.v200erratum7 . 10.1164/rccm.201905-1071ST Open DOISearch in Google Scholar

19. Masa JF, Mokhlesi B, Benítez I, Gomez de Terreros FJ, Sánchez-Quiroga MÁ, Romero A, et al. Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial. Lancet (London, England). 2019;393(10182): 1721–1732. doi:10.1016/S0140-6736(18)32978-7 Masa JF Mokhlesi B Benítez I Gomez de Terreros FJ Sánchez-Quiroga MÁ Romero A Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial . Lancet (London, England) . 2019 ; 393 ( 10182 ): 1721 – 1732 . 10.1016/S0140-6736(18)32978-7 Open DOISearch in Google Scholar

20. Patout M, Dantoing E, De Marchi M, Hart N, Murphy PB, Cuvelier A. Step-down from non-invasive ventilation to continuous positive airway pressure: a better phenotyping is required. Respirology (Carlton, Vic.). 2020;25(4): 456. doi:10.1111/resp.13746 Patout M Dantoing E De Marchi M Hart N Murphy PB Cuvelier A. Step-down from non-invasive ventilation to continuous positive airway pressure: a better phenotyping is required . Respirology (Carlton, Vic.) . 2020 ; 25 ( 4 ): 456 . 10.1111/resp.13746 Open DOISearch in Google Scholar

21. Xu J, Wei Z, Li W, Wang W. Effect of different modes of positive airway pressure treatment on obesity hypoventilation syndrome: a systematic review and network meta-analysis. Sleep Med. 2022 Mar;91:51-58. doi: 10.1016/j.sleep.2022.01.008. Epub 2022 Jan 13. PMID: 35272117. Xu J Wei Z Li W Wang W. Effect of different modes of positive airway pressure treatment on obesity hypoventilation syndrome: a systematic review and network meta-analysis . Sleep Med . 2022 Mar ; 91 : 51 - 58 . 10.1016/j.sleep.2022.01.008 . Epub 2022 Jan 13. 35272117 . Open DOISearch in Google Scholar

22. Andrade RGS, Masa JF, Borel JC, Drager LF, Genta PR, Mokhlesi B, et al. Impact of treating obesity hypoventilation syndrome on body mass index. Pulmonology. 2025;31(1): 2416816. doi:10.1016/j.pulmoe.2023.09.004 Andrade RGS Masa JF Borel JC Drager LF Genta PR Mokhlesi B Impact of treating obesity hypoventilation syndrome on body mass index . Pulmonology . 2025 ; 31 ( 1 ): 2416816 . 10.1016/j.pulmoe.2023.09.004 Open DOISearch in Google Scholar

23. Mokhlesi B, Won CH, Make BJ, Selim BJ, Sunwoo BY, ONMAP Technical Expert Panel. Optimal NIV Medicare Access Promotion: patients with hypoventilation syndromes: a technical expert panel report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society. Chest. 2021;160(5): e377–e387. doi:10.1016/j. chest.2021.06.083 Mokhlesi B Won CH Make BJ Selim BJ Sunwoo BY ONMAP Technical Expert Panel. Optimal NIV Medicare Access Promotion: patients with hypoventilation syndromes: a technical expert panel report from the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society . Chest . 2021 ; 160 ( 5 ): e377 – e387 . 10.1016/j.chest.2021.06.083 Open DOISearch in Google Scholar