Importance of proper ventilator support and pulmonary rehabilitation in obese patients with heart failure: Two case reports

Table 1 Demographic data

	Case 1	Case 2
Age	47	36
Gender	F	M
Height (cm)	163.5	172
Weight (kg)	130	167.1
Body mass index (kg/m2)	48.93	56.48
Past medical history
Hypertension	O	O
Diabetes mellitus	O	O
Heart failure	O	O
Pulmonary hypertension	O	O
Cor pulmonale	O	×
Chronic kidney disease	O	×
Bronchial asthma	O	×

F: Female; M: Male.

Table 2 Comparison of admission and discharge results

	Patient 1				Patient 2
	Adm	RM consult	Discharge	F/U (4 mo)	Adm	RM consult	Discharge	F/U (4 mo)
Height (cm)	163.5	163.5	163.5	163.5	172	172	172	172
Weight (kg)	130	105.5	98.2	88	167.1	138.4	135.7	138
BMI	48.63	39.47	36.73	32.92	56.48	46.78	45.87	46.65
Noninvasive ventilation
Mode			iVAPS	iVAPS			PCV	PCV
Setting			Target Va 8	Target Va 8			IPAP 19	IPAP 19
			PS 2-14	PS 2-14			EPAP 5	EPAP 5
			EPAP 4-10	EPAP 4-10
O2			4 L/min	4 L/min			4 L/min	4 L/min
Apply time			9 pm-7 am	9 pm-7 am			10 pm-6 am	10 pm-6 am
Daytime O2	15 L/min	15 L/min	1.5L/min	None	10 L/min	10 L/min	None	None
(reserve mask)
ABG test1
pH	↓7.307	7.354	7.39	-	↓7.148	7.351	7.406	-
PCO2 (mmHg)	↑97.1	↑96.7	↑51.7	-	↑110	↑74.9	37.7	-
PO2 (mmHg)	↓73.3	↓63.8	↓72.3	-	↓79	103	97.3	-
SaO2 (%)	93.2	88.6	94.3	-	91.7	97.5	98	-
Pulmonary function test
PCF (L/min)	NT	NT	260	-	NT	340	370	510
FVC (L)	NT	NT	2.27	3.21	NT	NT	4.72 (102%)	4.64 (101%)
			-0.75	-0.95
FEV1 (L)	NT	NT	1.71	2.39	NT	NT	3.46 (101%)	2.76
			-0.66	-0.93				-0.81
FEV1/FVC (%)	NT	NT	75	75	NT	NT	73	59
PEF (%)	NT	NT	72	-	NT	NT	84	56
6MWT	NT	NT	234 m	376 m	NT	389 m	480 m	549 m
AHI2	Not done						78.1/h

¹Measured in the morning (reflecting respiration values during sleep).

²Measured value use of polysomnography.

RM: Rehabilitation medicine; F/U: Follow up; BMI: Body mass index; NIV: Non-invasive ventilation; ABGA: Arterial blood gas analysis; PFT: Pulmonary function test; NT: Not testable; PCF: Peak cough flow; FVC: Forced vital capacity; FEV1: Forced expiratory volume in the first second; PEF: Peak expiratory flow; 6MWT: 6-minute walking test; AHI: Apnea/hypopnea index.