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Ms. G - PowerPoint PPT Presentation


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25 yobf Height 5’4” Weight 272 lbs. Ms. G. Chief Complaint. EDS - Epworth of 15/24 Nocturnal sleep disruption Shift worker (doesn’t like it) Snoring. Family History. Maternal HTN Mother has had a stroke. Obesity Hypoventilation and OSA. Oxyhemoglobin Dissociation Curve.

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slide1
25 yobf

Height 5’4”

Weight 272 lbs.

Ms. G
chief complaint
Chief Complaint
  • EDS - Epworth of 15/24
  • Nocturnal sleep disruption
  • Shift worker (doesn’t like it)
  • Snoring
family history
Family History
  • Maternal HTN
  • Mother has had a stroke
obesity hypoventilation and osa
Obesity Hypoventilation and OSA

Oxyhemoglobin Dissociation Curve

  • Excessive weight pushes against diaphragm causing shallow breathing
  • Baseline SaO2 <88%
  • Low Vt -high respiratory rate (attempt to maintain normal minute ventilation)

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

SaO2

10 20 30 40 50 60 70 80 90 100

PO2 mm Hg

conclusion
Conclusion
  • Severe OSA - Controlled with CPAP 13 cm H20
  • Patient referred to Pulmonary Department for work-up
  • Patient referred to ENT specialist