Pickwickian syndrome

Abdominal distention, as in peritonitis and ascites Extreme obesity (pickwickian syndrome)... 

The client has Pickwickian syndrome and falls asleep at inappropriate times. Which medication should the nurse prepare to administer ... 

OHS, previously called the Pickwickian syndrome (6), is defined as the association of obesity, sleep-disordered breathing (SDB) with daytime h)q)ersomnolence, and hypercapnia (Pacc>2 > 45 mmHg) in the absence of any other respiratory disease (Fig. 1). SDB can present as obstructive apneas and hypopneas, obstructive hypoventilation due to increased upper airway resistance, and/or central hypoventilation (7). The prevalence of OHS is 36% in patients with BMI between 35 and 40 kg/m, and 48%, if BMI equals or exceeds 50 (8). Without adequate treatment, patients with OHS develop cor pulmonale and recurrent episodes of hypercapnic respiratory failure, and loss of survival (Fig. 2). OHS is one of the many etiologies of CRF and has become a growing indication to initiate longterm noninvasive ventilation (NIV) in most European countries (9,10). 

Burwell CS, Robin ED, Whaley R, et al. Extreme obesity associated with alveolar hypoventilation. A Pickwickian syndrome. Am J Med 1956 21 811-816. 

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