Obesity Hypoventilation Syndrome - Evaluation and Management

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at Copyright © 2019 All rights reserved ATSOHS1973 Disclaimer is pocket guide attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. is pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations AHI, apnea-hypopnea index; ATS, American oracic Society, NIV, noninvasive ventilation; OHS, obesity hypoventilation syndrome; PaCO 2 , partial pressure of carbon dioxide; PAP, positive airway pressure; SDB, sleep-disordered breathing ; SpO 2 , oxygen saturation by pulse oximetry Source Mokhlesi B et al. Evaluation and management of obesity hypoventilation syndrome: an official American oracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019;200(4): e6–e24. Table 2. Interpretation of Strong and Conditional Recommendations Strong recommendation Conditional recommendation Patients Most individuals in this situation would want the recommended course of action, and only a small proportion would not. Most individuals in this situation would want the suggested course of action, but many would not. Clinicians Most individuals should receive the recommended course of action. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. Recognize that different choices will be appropriate for different patients and that you must help each patient arrive at a management decision consistent with her or his values and preferences. Decision aids may well be useful in helping individuals making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working toward a decision. Policy makers e recommendation can be adopted as policy in most situations, including for use as performance indicators. Policy making will require substantial debate and involvement of many stakeholders. Policies are also more likely to vary between regions. Performance indicators would have to focus on the fact that adequate deliberation about the management options has taken place.

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