Pulmonary Rehabilitation: Pulmonary Rehabilitation |

Noninvasive Positive Pressure Ventilation to Relieve Dyspnea of COPD Patients During Exercise Training: A Prospective Study FREE TO VIEW

Boxue Han, MDS
Author and Funding Information

The Second Artillery General Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A492. doi:10.1016/j.chest.2016.02.513
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SESSION TITLE: Pulmonary Rehabilitation

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To determine whether noninvasive ventilation support during exercise of a program in the stable COPD patients could enable the individuals to release dyspnea and increase activity tolerance.

METHODS: A randomized, self-controlled and prospective observational study, 20 participants with the severe but stable COPD (FEV1/pre:45.6±2.6%) were recruited. Each subject completed five kinds of tests, on the way to doing treadmill walking exercise as quickly as possible, for a period of 16 days. 5 kinds of tests were included: Test0: baseline without ventilator support. Both Test1 and Test2 were required with the ventilator support (NIPPV via nozzle) in S mode (spontaneous mode) while having a rest: two different pressure levels (IPAP/EPAP:18/8cmH2O and 14/4cmH2O) were in Test1 and Test2 respectively. Test3 and Test4: both exercise and rest were aided with ventilator (NIPPV via total face mask), S mode was applied in Test3, besides, AVAPS-AE (average volume assured pressure support auto-EPAP, AVAPS-AE) mode was adopted in Test4 (parameters:maximum EPAP=8cmH2O, minimum EPAP=4cmH2O, Rate=3cmH2O/min, tidal volume depending on individual BMI). Duration of the walk, distance walked and recovery time were recorded in time. During the exercise sessions, heart rate, respiratory rate, pulse oxygen saturation and Borg score at different time when T1, T2, T3 (the 1st,3rdand 5th minute during walking) and T4, T5, T6 (the 1st, 2nd and 3rd minute during resting) were monitored continuously. These measures above were statistically analyzed.

RESULTS: 1.Compared with the test 0, the duration of recovery in Test1, Test3 and Test4 were significantly shorter (p<0.05). No significant changes of distance and dutation of the walk were observed in test 1,2,3,4 (p>0.05). 2. RR, SpO2 (%), HR and Borg score at T5 in Test1, Test3 and Test4 were lower than test 0 (p<0.05) and these measures at T2 in Test4 were more lower (p<0.05). Compared with Test0, SpO2, RR, HR and Borg score in other four tests did not change greatly (p>0.05).

CONCLUSIONS: Noninvasive positive pressure ventilation can relieve shortness during exercising quickly and enhance efficiency of pulmonary rehabilitation in the stable COPD patients. AVAPS-AE mode maybe more likely to improve the measures above, especially in synchronization and activity tolerance, worthy of promotion.

CLINICAL IMPLICATIONS: To release the shortness of the patients with COPD during pulmonary rehabilitation.

DISCLOSURE: Boxue Han: Grant monies (from industry related sources): PHILIP GROUP




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