Instantaneous restoration of cardiac output by noninvasive positive pressure ventilation in a patient with obesity hypoventilation syndrome

Summary We report a 30-year-old man with severe obesity hypoventilation syndrome (OHVS) complicated by right-sided heart failure. Polysomnography revealed severe obstructive sleep apnea with apnea–hypopnea index (AHI) 70.4/h and gradual decrease in minimum oxygen saturation (SpO 2 ) from 86% before sleep to 36% during sleep. Cardiac output (CO) was suppressed from 3.9L/min before sleep to 2.5L/min during sleep. Noninvasive positive pressure ventilation (NPPV) treatment drastically restored CO to the level before sleep, and improved AHI to 9.4/h and minimum SpO 2 to 87%. NPPV may provide rapid and powerful symptom relief in patients with OHVS complicated with right sided heart failure.