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Ms. G

25 yobf Height 5’4” Weight 272 lbs. Ms. G. Chief Complaint. EDS - Epworth of 15/24 Nocturnal sleep disruption Shift worker (doesn’t like it) Snoring. Family History. Maternal HTN Mother has had a stroke. Obesity Hypoventilation and OSA. Oxyhemoglobin Dissociation Curve.

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Ms. G

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  1. 25 yobf Height 5’4” Weight 272 lbs. Ms. G

  2. Chief Complaint • EDS - Epworth of 15/24 • Nocturnal sleep disruption • Shift worker (doesn’t like it) • Snoring

  3. Family History • Maternal HTN • Mother has had a stroke

  4. Obesity Hypoventilation and OSA Oxyhemoglobin Dissociation Curve • Excessive weight pushes against diaphragm causing shallow breathing • Baseline SaO2 <88% • Low Vt -high respiratory rate (attempt to maintain normal minute ventilation) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% SaO2 10 20 30 40 50 60 70 80 90 100 PO2 mm Hg

  5. Oximetry Strip Chart Trending

  6. Conclusion • Severe OSA - Controlled with CPAP 13 cm H20 • Patient referred to Pulmonary Department for work-up • Patient referred to ENT specialist

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