PPC ou VNI dans le SAOS associé au syndrome obésité-hypoventilation?

Obesity-hypoventilation syndrome (OHS) is defined by the combination of obesity, abnormal respiratory events during sleep and hypercapnia. Continuous Positive airway pressure represents the first-line therapy for OHS. If residual hypoventilation persists in REM under CPAP, noninvasive ventilation (NIVis) is required. Positive expiratory pressure has to be fixed at high level (8-10 cmH2O) to maintain upper airway patency and pressure is upport is titrated to suppress REM hypoventilation. A high backup rate is recommended in OHS. Volume-targeted ventilation has not demonstrated superiority compared to classical pressure support in these patients.