Upon arrival at Tam Anh General Hospital, Ho Chi Minh City, Mr. Toan weighed 98 kg. Tests revealed low blood pH, CO2 retention, and grade three fatty liver. Doctors diagnosed respiratory acidosis, prescribing bronchodilators to alleviate acute shortness of breath, followed by weight loss treatment.

After ruling out other respiratory conditions such as pneumonia and asthma, Dr. Pham Thi Thu Ha, from the Department of Endocrinology and Diabetes, diagnosed the patient with obesity-induced respiratory acidosis. This is a dangerous and uncommon complication of severe sleep apnea syndrome in obese individuals.

Dr. Ha explained that normally, lungs take in oxygen and distribute it to the body's organs via the bloodstream. After use, carbon dioxide (CO2) is expelled. If CO2 is not expelled, it accumulates, lowering the blood's pH level. This reduces oxygen levels in the blood, leading to chronic hypoxia and an increase in blood acidity, known as acidosis.

Furthermore, Mr. Toan also suffered from secondary polycythemia, resulting in a higher-than-normal red blood cell count. This condition often results from respiratory acidosis, which increases the circulation of red blood cells in the body.

Dr. Ha consults Mr. Toan on obesity treatment. *Photo: Tam Anh General Hospital*

Patients with respiratory acidosis may exhibit shortness of breath, anxiety, wheezing, and sleep disturbances. In some cases, they may experience cyanosis due to hypoxemia, altered mental status, muscle jerks, seizures, cerebral vasodilation (leading to memory loss), pulmonary hypertension, and heart failure.

Mr. Toan was prescribed a personalized, multi-modal weight loss regimen, combining medication, dietary adjustments, adequate rest, and appropriate exercise.

With the help of appetite suppressants and 2-3 regular gym sessions per week, Mr. Toan lost 14 kg in three months. His fatigue and shortness of breath significantly decreased, and his night sleep improved. Blood test results showed his red blood cell count was within a safe range. His blood pH level stabilized, and the respiratory acidosis significantly improved.

Duc Hanh

*The patient's name has been changed