Document Detail


Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  12894005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In patients with chronic obstructive pulmonary disease, pulmonary rehabilitation has been demonstrated to increase exercise capacity and reduce dyspnea. In the most disabled patients, the intensity of exercise during the training sessions is limited by ventilatory pump capacity. This study therefore evaluated the beneficial effect of noninvasive ventilation (NIV) support during the rehabilitation sessions on exercise tolerance. METHODS: This study included 14 patients with stabilized chronic obstructive pulmonary disease, ages 63 +/- 7 years, with a forced expiratory volume in 1 second (FEV(1)) 31.5% +/- 9.2% of predicted value. All 14 patients participated in an outpatient pulmonary rehabilitation program. Seven of the patients trained with NIV during the exercise sessions (NIV group), whereas the remaining seven patients breathed spontaneously (control group). Exercise tolerance was evaluated during an incremental exercise test and during constant work rate exercise at 75% of peak oxygen consumption (VO(2)) before and after the training program. RESULTS: The application of noninvasive ventilation increased exercise tolerance, reduced dyspnea, and prevented exercise-induced oxygen desaturation both before and after training. The pressure support was well tolerated by all the patients during the course of the training program. In the NIV group, training induced a greater improvement in peak VO(2) (18% vs 2%; P <.05) and a reduced ventilatory requirement for maximal exercise, as compared with the control group. The constant work rate exercise duration increased similarly in both groups (116% vs 81%, nonsignificant difference), and posttraining blood lactate was decreased at isotime (P <.05 in both groups), but not at the end of the exercise. CONCLUSION: In this pilot study, exercise training with noninvasive ventilation support was well tolerated and yielded further improvement in the increased exercise tolerance brought about by pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. This improved exercise tolerance is partly explained by a better ventilatory adaptation during exercise.
Authors:
Frédéric Costes; André Agresti; Isabelle Court-Fortune; Frédéric Roche; Jean-Michel Vergnon; Jean Claude Barthélémy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation     Volume:  23     ISSN:  0883-9212     ISO Abbreviation:  J Cardiopulm Rehabil     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-08-01     Completed Date:  2003-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8511296     Medline TA:  J Cardiopulm Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  307-13     Citation Subset:  IM    
Affiliation:
Service d'Explorations Fonctionnelles Cardiorespiratoires, Laboratoire de Physiologie, GIP Exercice, CHU Saint Etienne, France. costes@univ.st.etienne.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Exercise Test
Exercise Therapy
Exercise Tolerance*
Female
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive / rehabilitation*
Respiration, Artificial*

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