A randomised controlled trial of CPAP versus non-invasive ventilation for initial treatment of obesity hypoventilation syndrome

In those with recently diagnosed OHS, this project found that CPAP and Bi-level PAP had similar rates of treatment failure and provided similar improvements in control of ventilatory failure, HRQoL and cardiovascular risk factors after 3 months of treatment,

although there was a trend for ventilatory failure to remit more rapidly in the Bi-level PAP group. The project population included those with severe ventilatory failure and also used a controlled mode of ventilation in the Bi-level PAP group in order to provide this therapy in its optimal form and maximise the likelihood of identifying a difference between the groups. Persistent mild ventilatory failure was common after 3 months

of treatment, with the severity of ventilatory failure at presentation the only clear predictor. These findings suggest that CPAP can be safely used to treat isolated OHS of all severities following initial stabilisation and with careful monitoring.

2016Thorax RCT CPAP vs NIV OHS

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