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Ventilatory Support During Exercise in Patients With Pulmonary Tuberculosis Sequelae FREE TO VIEW

Tomomasa Tsuboi; Motoharu Ohi; Kazuo Chin; Hiromichi Hirata; Naoki Otsuka; Hideo Kita; Kenshi Kuno
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From the Department of Clinical Physiology, Chest Disease Research Institute, Kyoto University, Kyoto, Japan

1997 by the American College of Chest Physicians

Chest. 1997;112(4):1000-1007. doi:10.1378/chest.112.4.1000
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Study objective: The aim of this study was to determine whether intermittent positive pressure ventilation through a nasal mask (NIPPV) applied during exercise in patients with pulmonary tuberculosis sequelae (PTS) could improve arterial blood gas measurements, ameliorate breathlessness, and increase exercise endurance.

Patients: Seven PTS patients with a severe restrictive ventilatory defect (mean [SD] vital capacity, 1.02 [0.25] I) enrolled in this study had experienced NIPPV previously, and were familiar with the procedure.

Design: The patients underwent four constant-load cycle ergometer tests in the supine position to tolerance. The tests were performed with and without NIPPV, while breathing normoxic air (Air) or supplemental oxygen (O2; 35%). NIPPV was delivered during exercise in a controlled, volume-cycled mechanical ventilation mode, and the ventilator settings were modulated manually to meet patients' respiratory demands as estimated from the airway pressure waveform and the patient's breathlessness.

Results: All patients matched their breathing to the ventilator cycle during most of the exercise while receiving NIPPV. NIPPV significantly prolonged their exercise endurance time, from a mean (SD) of 180 (58) s to 310 (96) s in Air, and from 227 (64) s to 465 (201) s in O2. During exercise, NIPPV effectively decreased their breathlessness and significantly improved arterial blood gas measurements.

Conclusions: NIPPV applied during exercise can effectively support ventilation, significantly ameliorate breathlessness, and consequently improve exercise endurance in patients with PTS.




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