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Malignant Obesity Hypoventilation Syndrome (MOHS) of Marik and Desai

Description

Marik and Desai described the Malignant Obesity Hypoventilation Syndrome (MOHS) in obese patients admitted to the intensive care unit (ICU). These patients may be misdiagnosed, undertreated and have a poor prognosis. The authors are from Eastern Virginia Medical School.


 

Key features:

(1) body mass index > 40 kg per square meter

(2) hypercapnia (PaCO2 > 45 mm Hg)

 

Accompanying findings:

(1) pulmonary hypertension which may be misdiagnosed as asthma or COPD

(2) left ventricular hypertrophy and/or diastolic dysfunction

(3) elevated C-reactive protein (CRP)

(4) metabolic syndrome with type 2 diabetes mellitus and/or NASH

(5) high resource utilization with frequent hospital readmissions

(6) risk for multi-organ failure

 

A patient with MOHS may benefit from bariatric surgery but the patient may be a high risk candidate.

 


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