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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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