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Pulmonary Rehabilitation |

The Impact of Noninvasive Open Ventilation (NIOV) in Pulmonary Rehabilitation

onyekachi obi, MD; Mehdi Shahidi, MD; Joni Colle, RN; Viral Doshi, MD; Robel Haile, MD; Joseph Henkle, MD
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SIU School of Medicine, Springfield, IL


Chest. 2015;148(4_MeetingAbstracts):914A. doi:10.1378/chest.2270641
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Abstract

SESSION TITLE: Pulmonary Rehabilitation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The purpose of this pilot study is to assess the dyspnea severity and exercise capacity utilizing standardized scales in patients with COPD who receive oxygen therapy through either nasal cannula or NIOV interface during their standard pulmonary rehabilitation program.

METHODS: A total of 12 patients were enrolled in this pilot study. Among these patients two were lost to follow up and one patient expired. Using a 1:1 randomization, eligible patients who consented to participate in the study were blindly assigned receive oxygen either through nasal cannula (O2+NC) or through NIOV device (O2+NIOV). We assessed the changes in MMRC (Modified medical research council) dyspnea score, CAT (COPD Assesmet Test) score, and 6 minute walk distance (6-MWD) in both arms and compared the data obtained in the beginning and the end of the 10-week standard pulmonary rehabilitation program.

RESULTS: We collected data for nine patients with five patients on NC arm and four patients on NIOV arm. Average MMRC score for NC arm was 2.2 on week 1 and 3 by week 10; for NIOV patients was 2.12 on week 1 and 1.75 by week 10. The average CAT score for NC patients was 21.4 on week 1 and 18.8 by week 10; for NIOV arm was 26.5 on week 1 and 21.25 by week 10. Average improvement in 6-MWD for NC arm was 362 feet per patient, while for NIOV arm was 250 feet per patient.

CONCLUSIONS: From this pilot study we concluded that compared to NC arm, the NIOV system resulted in subjective improvement in dyspnea, exercise tolerance and quality of life, while the COPD patients on the NC arm had an objective improvement in their 6-MWD.

CLINICAL IMPLICATIONS: Exercise intolerance is the most perceived leading complaint of a patient with advanced COPD. Inability to ambulate due to severe dyspnea inevitably worsens the quality of life. Pulmonary rehabilitation has become the standard of care for all patients with COPD and has shown significant improvement in quality of life, dyspnea, exercise tolerance, and ability to perform activities of daily living. NIOV system was developed as a wearable ventilation system for patients with respiratory failure in order to improve their exercise tolerance and dyspnea. This system delivers both augmented and supplemental oxygen and is able to detect patient’s spontaneous breathing and delivers synchronized volumes of oxygen. We demonstrated that NIOV system is promising for improvement in exercise tolerance during rehabilitation, however further study with a larger volume of patients is necessary.

DISCLOSURE: The following authors have nothing to disclose: onyekachi obi, Mehdi Shahidi, Joni Colle, Viral Doshi, Robel Haile, Joseph Henkle

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