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An in-depth examination of obesity as a global health issue, its prevalence, and the associated risks, particularly in relation to lung function. It covers various aspects such as obesity classifications, body composition, pulmonary function, gas exchange, and control of breathing. The document also discusses the use of non-invasive ventilation in managing obesity-related respiratory conditions.
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Severe Obesity BMI(kg/m2 )^23
Body fat (%)^22
Body weight (kg)^65
Fat-free mass (kg)^51
Body cell mass (kg)^27
Total body water (L)^38
REE (watts)^68
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-^ Spirometry in individuals with obesity hypoventilation syndrome (OHS)usually reveals a more severe restrictive pattern with reductions in–^ TLC, VC,–^ MVV, and–^ peak inspiratory flow rate•^ This appears to be related to weakness of the respiratory muscles.•^ The ERV may be reduced to 35% of predicted and the FVC to 60% ofpredicted•^ The adverse effects of obesity on pulmonary function cannot be entirelyexplained by the absolute load of adipose tissue on the chest wall becausesimilar degrees of obesity in simple obesity and OHS result in differentpatterns of lung volume changes .•^ The single-breath diffusion capacity is usually normal or increased insimple obesity and slightly reduced in OHS
-^ OHS>Obesity generally lowers compliance of the lung, chest wall, and totalrespiratory system. –^ due to weight pressing on the thorax and abdomen thereby imposing an elastic load.–^ threshold-type load on the chest wall in which pleural pressure must be lowered toa sufficient degree before inspiratory flow can begin.•^ Specific airway conductance may be reduced to 50% to 70% of normal.•^ FEV1 /FVC ratio is normal^ –^ increased airway resistance in obesity appears to lie in lung tissue and smallairways–^ Impediment to breathing in obesity results from a two- to threefold increase inintra-abdominal pressure•^ The transition from upright to the supine position reduces lung volume due toincreased intra-abdominal pressure & promotes expiratory flow limitation duringtidal breathing •^ The work of breathing is 60% higher in simple obesity and may be as much as250% higher in OHS with an Increase in the energy cost of breathing; the oxygencost of breathing at rest •^ This places obese patients at risk for respiratory failure during conditionscharacterized by increased ventilatory demands such as an intercurrent illness . Docsity.com