Pickwickian Syndrome (Severe Obesity)
Description
This disorder is related to severe obesity that causes a restrictive lung disease. The excess body weight increases the work of breathing. Patients are unable to breath deep enough and have low oxygen levels (hypoxia) especially at night. The hypoxia can result in permanent heart and lung damage, and when severe can even be lethal.
Symptoms
Excessive daytime sleepiness, falling asleep during the day, increased risk for accidents or mistakes at work, depression, shortness of breath, fatigue.
Tests
A history and physical exam will be performed. Tests to confirm the disorder include: Sleep study, lung (pulmonary) function, and an arterial blood gas.
- CBC
- Chem 12
- Troponin
- X-Ray
- EKG
Treatment
The treatment involves improving the breathing effort and the options include: supplemental oxygen, non-invasive mechanical ventilation (BiPAP or CPAP), and mechanical ventilation through an incision in the neck (tracheostomy). Weight loss can cure the disorder.
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