Fig. 01 -

Title Slide

Fig. 02 -

Clinical Trials

Fig. 03 -

Obesity Related Respiratory Failures

Fig. 04 -

Size of the Problem

Fig. 05 -

Adiposity and Risk of Death

Fig. 06 -

Waist Size

Fig. 07 -

BMI and CVD Risks

Fig. 08 -

Lane Fox Clinical Experience

Fig. 09 -

Change in Patient Demographics

Fig. 10 -

Statistics

Fig. 11 -

The Clinical Problem

Fig. 12 -

Clinical Discussion

Fig. 13 -

Obesity-Related Respiratory Failure

Fig. 14 -

Hypercapnic OSA & OHS Graphs

Fig. 15 -

Hypercapnic OSA Graph

Fig. 16 -

Hypercapnic OSA & OHS Graphs

Fig. 17 -

Hypercapnic OHS Graphs

Fig. 18 -

Clinical Data

Fig. 19 -

BMI, OSA, OHS

Fig. 20 -

SDB and Hypercapnia

Fig. 21 -

Cohort Study & Clinical Tests

Fig. 22 -

Inclusion Criteria

Fig. 23 -

ROC curves for FVC and SpO₂

Fig. 24 -

Respratory Screening

Fig. 25 -

Key Messages

Fig. 26 -

Identify the Patients

Fig. 27 -

Raised Bicarbonates

Fig. 28 -

Physiological Spectrum

Fig. 29 -

Age, Weight, BMI

Fig. 30 -

PaO₂, PaCO₂

Fig. 31 -

Respiratory Rate

Fig. 32 -

EtCO₂

Fig. 33 -

Minute Ventilation Rise

Fig. 34 -

Oxygen Desaturation and Apnoea/Hypopnoea

Fig. 35 -

Mean, Time, Percentage

Fig. 36 -

CO₂ Response

Fig. 37 -

Obesity-Related Respiratory Failure

Fig. 38 -

Base Excess ≥ 2 mmols

Fig. 39 -

Management Direction

Fig. 40 -

Optimum Management

Fig. 41 -

CPAP

Fig. 42 -

CPAP vs Bilevel Suport

Fig. 43 -

Outcome and Change

Fig. 44 -

No Difference

Fig. 45 -

Exclusion Criteria

Fig. 46 -

Hypercapnic OSA

Fig. 47 -

PSV, Back UP Rate & Tidal Volume

Fig. 48 -

Pressure Adjustment and Support

Fig. 49 -

Distorted breathing and worse sleep quality

Fig. 50 -

Better, Worse or the Same

Fig. 51 -

Targeted vs Fixed Volume Pressure Support

Fig. 52 -

Automated Volume vs Protocolised Pressure

Fig. 53 -

Set Up Comparison

Fig. 54 -

Baseline Data

Fig. 55 -

3-Month Follow up Data

Fig. 56 -

No Difference Between the Ventilatory Modes

Fig. 57 -

No difference in Sleep Disruption

Fig. 58 -

Volume Targeted vs Nurse-Led Protocolised

Fig. 59 -

Weight Gain & Reduced HRQL

Fig. 60 -

Reduced Physical Activity-Actigram

Fig. 61 -

3-Month Follow up Cohort Data

Fig. 62 -

Correlation in change in activity

Fig. 63 -

What about back up rate?

Fig. 64 -

'Mandatory' vs. 'Spontaneous' Modes

Fig. 65 -

Clinical Outcomes at 3 Months

Fig. 66 -

Effective Adherence Time

Fig. 67 -

Adherance to Reduce PaCO₂

Fig. 68 -

NIV Treatment

Fig. 69 -

Novel Autotititrating Devises

Fig. 70 -

Safety and Efficacy

Fig. 71 -

COPD-OSA overlap is a problem

Fig. 72 -

Auto-titrating IPAP and EPAP

Fig. 73 -

Importance of back up rate

Fig. 74 -

Autotitrating IPAP, EPAP ad Back Up Rate

Fig. 75 -

Patient Flow Protocol

Fig. 76 -

Gas exchange and polysomnography

Fig. 77 -

No Difference

Fig. 78 -

Gas exchange & actigraphy

Fig. 79 -

No Difference

Fig. 80 -

Ventilator Settings

Fig. 81 -

Auto-titrating NIV device

Fig. 82 -

Conclusion

Fig. 83 -

Summary

Fig. 84 -

Questions?

Fig. 85 -

Contributors

Fig. 86 -

Photos