Pickwickian Syndrome

Excerpt

In 1836, Charles Dickens published his serialized book “The Posthumous Papers of the Pickwick Club” in which he described obesity hypoventilation syndrome (OHS), which is defined as alveolar hypoventilation in an obese individual during wakefulness that cannot be explained to other conditions that lead to hypercapnia, such as chronic obstructive lung disease (COPD) or obstructive sleep apnea.

Obesity hypoventilation syndrome (OHS) is defined as the presence of awake alveolar hypoventilation characterized by daytime hypercapnia (arterial PaCO₂ greater than 45 mm Hg [5.9 kPa]) that is thought to be a consequence of diminished ventilatory drive and capacity related to obesity (BMI over 30 kg/m²) in the absence of an alternate respiratory, neuromuscular, or metabolic explanation for hypoventilation. The mechanism of OHS is related to a decrease in central respiratory drive, reduced hypercapnic ventilatory response, and a restrictive lung disease pattern.