A: The Pickwickian syndrome, or obesity hypoventilation syndrome, occurs in overweight patients, typically during anesthesia. Patients cannot oxygenate properly because of fat reducing their respiratory function. Decreased lung capacity leads to a heavier workload on the heart, resulting in both cardiovascular and respiratory compromise. This leads to hypoxemia (low oxygen levels) and hypercapnia (increased CO2 levels). The solution is to assist with ventilation, manually or with a ventilator. The term is borrowed from human medicine. The name originated from an overweight Charles Dickens character who suffered from respiratory difficulties. How did you do? Let us know in the comments below.