An Indonesian adult with obesity hypoventilation syndrome: a case report

Introduction and importance: Obesity hypoventilation syndrome (OHS) is an often overlooked and limited case with other conditions that can cause hypoventilation. Case presentation: An Indonesian female, 22 years old, always feels sleepy, has difficulty concentrating and controlling her appetite. The patient had a fever, respiratory rate of 32 ×/min, pulse rate of 115 ×/min, apathy, obesity (BMI =46.6 kg/m2), and she used oxygen therapy with a non-rebreathing mask of 10 l/min (SO2 of 89%). The patients had daytime hypercapnia & alveolar hypoventilation without other causes of hypoventilation. She was likely to have a chronic condition with relatively stable symptoms that had fallen into a state of acute on chronic hypercapnic respiratory failure. The patient used mechanical ventilation and received supportive management. After 19 days of treatment, the patient’s condition improved, and it was recommended to lose weight gradually. In 1-week post hospitalization, the patient experienced a weight loss of 5 kg. Discussion: Mechanical ventilation, supportive management, and decreased body weight of 25–30% gradually have improved prognosis in OHS patients. Bariatric surgery is carried out when the patient cannot lose weight with diet and exercise. Conclusion: OHS management includes oxygen therapy and gradually decreased body weight.