{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:32:08Z","timestamp":1774258328958,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Anesthesiology"],"published-print":{"date-parts":[[2021,8,25]]},"abstract":"<jats:p>Obesity hypoventilation syndrome (OHS) is a disorder in which patients with a body mass index \u226530\u2009kg\/m2 develop awake hypercapnia with a partial pressure of carbon dioxide \u226545\u2009mm Hg, in the absence of other diseases that may produce alveolar hypoventilation. Additional clinical features include sleep disordered breathing, restrictive lung disease, polycythemia, hypoxemia, and an increased serum bicarbonate concentration (\u226527\u2009mEq\/L). Anesthesia providers should be familiar with OHS because it is often undiagnosed, it is associated with a higher mortality rate than obstructive sleep apnea, and it is projected to increase in prevalence along with the obesity epidemic. In this case, a 33-year-old obese woman with presumed OHS developed respiratory acidosis during induction of labor. Continuous positive airway pressure treatment was initiated, but the patient continued to have hypercapnia. A cesarean delivery was recommended. The patient had baseline orthopnea due to her body habitus; thus, despite adequate labor analgesia, a cesarean delivery was completed with general endotracheal anesthesia. We believe this patient had OHS despite a serum bicarbonate &lt;27\u2009mEq\/L, a partial pressure of oxygen &gt;70\u2009mm Hg, and a hemoglobin &lt;16\u2009g\/dL, which would typically rule out OHS. Pregnant women experience a decrease in serum bicarbonate concentration due to progesterone-mediated hyperventilation, an increase in arterial oxygenation from increased minute ventilation and higher cardiac output, and a decrease in hemoglobin due to the physiologic anemia of pregnancy. Thus, OHS may be defined differently in pregnant than in non-pregnant patients.<\/jats:p>","DOI":"10.1155\/2021\/8096212","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T14:38:25Z","timestamp":1629988705000},"page":"1-7","source":"Crossref","is-referenced-by-count":3,"title":["Diagnosis and Management of Obesity Hypoventilation Syndrome during Labor"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8285-7811","authenticated-orcid":true,"given":"Brandon M.","family":"Togioka","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA"},{"name":"Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah S.","family":"McConville","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA"},{"name":"Department of Neurology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael M","family":"Penchoen-Lind","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1784-0749","authenticated-orcid":true,"given":"Katie J.","family":"Schenning","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-122mg"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.2.369"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2986"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201905-1071st"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0097-2018"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0b013e31825add60"},{"issue":"10","key":"7","first-page":"1347","article-title":"Obesity hypoventilation syndrome: a state-of-the-art review","volume":"55","author":"B. 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