Cargando…

Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial

The effects of non-invasive ventilation (NIV) in addition to supplemental oxygen on exercise performance in patients with chronic obstructive pulmonary disease (COPD) with hyperinflation and exercise-induced desaturation (EID) remain unclear. We hypothesized that these patients would benefit from NI...

Descripción completa

Detalles Bibliográficos
Autores principales: Koopman, Maud, Spruit, Martijn A., Franssen, Frits M.E., Delbressine, Jeannet, Wouters, Emiel F.M., Mathew, Denny, Vink, Anton, Vanfleteren, Lowie E.G.W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912429/
https://www.ncbi.nlm.nih.gov/pubmed/31752201
http://dx.doi.org/10.3390/jcm8112012
_version_ 1783479453927604224
author Koopman, Maud
Spruit, Martijn A.
Franssen, Frits M.E.
Delbressine, Jeannet
Wouters, Emiel F.M.
Mathew, Denny
Vink, Anton
Vanfleteren, Lowie E.G.W.
author_facet Koopman, Maud
Spruit, Martijn A.
Franssen, Frits M.E.
Delbressine, Jeannet
Wouters, Emiel F.M.
Mathew, Denny
Vink, Anton
Vanfleteren, Lowie E.G.W.
author_sort Koopman, Maud
collection PubMed
description The effects of non-invasive ventilation (NIV) in addition to supplemental oxygen on exercise performance in patients with chronic obstructive pulmonary disease (COPD) with hyperinflation and exercise-induced desaturation (EID) remain unclear. We hypothesized that these patients would benefit from NIV and that this effect would be an add-on to oxygen therapy. Thirteen COPD patients with a residual volume >150% of predicted, normal resting arterial oxygen pressure (P(a)O(2)) and carbon-dioxide pressure (P(a)CO(2)) and EID during a six-minute walk test were included. Patients performed four constant work-rate treadmill tests, each consisting of two exercise bouts with a recovery period in between, wearing an oronasal mask connected to a ventilator and oxygen supply. The ventilator was set to the following settings in fixed order with clockwise rotation: Sham (continuous positive airway pressure (CPAP) 2 cm H(2)O, FiO(2) 21%), oxygen (CPAP 2 cm H(2)O, FiO(2) 35%), NIV and oxygen (inspiratory positive airway pressure (IPAP) 14 cm H(2)O/expiratory positive airway pressure (EPAP) 6 cm H(2)O, inspired oxygen fraction (FiO(2)) 35%), intermittent (walking: Sham setting, recovery: NIV and oxygen setting). During the first exercise, bout patients walked further with the oxygen setting compared to the sham setting (225 ± 107 vs 120 ± 50 meters, p < 0.05), but even further with the oxygen/NIV setting (283 ± 128 meters; p < 0.05). Recovery time between two exercise bouts was shortest with NIV and oxygen. COPD patients with severe static hyperinflation and EID benefit significantly from NIV in addition to oxygen during exercise and recovery.
format Online
Article
Text
id pubmed-6912429
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-69124292020-01-02 Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial Koopman, Maud Spruit, Martijn A. Franssen, Frits M.E. Delbressine, Jeannet Wouters, Emiel F.M. Mathew, Denny Vink, Anton Vanfleteren, Lowie E.G.W. J Clin Med Article The effects of non-invasive ventilation (NIV) in addition to supplemental oxygen on exercise performance in patients with chronic obstructive pulmonary disease (COPD) with hyperinflation and exercise-induced desaturation (EID) remain unclear. We hypothesized that these patients would benefit from NIV and that this effect would be an add-on to oxygen therapy. Thirteen COPD patients with a residual volume >150% of predicted, normal resting arterial oxygen pressure (P(a)O(2)) and carbon-dioxide pressure (P(a)CO(2)) and EID during a six-minute walk test were included. Patients performed four constant work-rate treadmill tests, each consisting of two exercise bouts with a recovery period in between, wearing an oronasal mask connected to a ventilator and oxygen supply. The ventilator was set to the following settings in fixed order with clockwise rotation: Sham (continuous positive airway pressure (CPAP) 2 cm H(2)O, FiO(2) 21%), oxygen (CPAP 2 cm H(2)O, FiO(2) 35%), NIV and oxygen (inspiratory positive airway pressure (IPAP) 14 cm H(2)O/expiratory positive airway pressure (EPAP) 6 cm H(2)O, inspired oxygen fraction (FiO(2)) 35%), intermittent (walking: Sham setting, recovery: NIV and oxygen setting). During the first exercise, bout patients walked further with the oxygen setting compared to the sham setting (225 ± 107 vs 120 ± 50 meters, p < 0.05), but even further with the oxygen/NIV setting (283 ± 128 meters; p < 0.05). Recovery time between two exercise bouts was shortest with NIV and oxygen. COPD patients with severe static hyperinflation and EID benefit significantly from NIV in addition to oxygen during exercise and recovery. MDPI 2019-11-18 /pmc/articles/PMC6912429/ /pubmed/31752201 http://dx.doi.org/10.3390/jcm8112012 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Koopman, Maud
Spruit, Martijn A.
Franssen, Frits M.E.
Delbressine, Jeannet
Wouters, Emiel F.M.
Mathew, Denny
Vink, Anton
Vanfleteren, Lowie E.G.W.
Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title_full Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title_fullStr Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title_full_unstemmed Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title_short Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial
title_sort effects of non-invasive ventilation combined with oxygen supplementation on exercise performance in copd patients with static lung hyperinflation and exercise-induced oxygen desaturation: a single blind, randomized cross-over trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912429/
https://www.ncbi.nlm.nih.gov/pubmed/31752201
http://dx.doi.org/10.3390/jcm8112012
work_keys_str_mv AT koopmanmaud effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT spruitmartijna effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT franssenfritsme effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT delbressinejeannet effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT woutersemielfm effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT mathewdenny effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT vinkanton effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial
AT vanfleterenlowieegw effectsofnoninvasiveventilationcombinedwithoxygensupplementationonexerciseperformanceincopdpatientswithstaticlunghyperinflationandexerciseinducedoxygendesaturationasingleblindrandomizedcrossovertrial