Document Detail


Use of continuous negative pressure around the chest increases exercise performance in chronic obstructive pulmonary disease patients: a pilot study.
MedLine Citation:
PMID:  21369549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) often have intrinsic positive end-expiratory pressure. Continuous positive airway pressure has been shown to decrease the inspiratory work of breathing and increases exercise capacity in these patients.
OBJECTIVE: To determine whether continuous negative pressure (CNP) around the chest is able to bring the positive end-expiratory pressure closer to atmospheric pressure, thereby reducing the threshold load and increasing exercise capability.
METHODS: A pilot study was undertaken with eight COPD patients who had been hospitalized for exacerbation and were close to discharge. For CNP, a shell (around the thorax from under the axillae to the mid abdomen) and wrap were used. Each of the eight patients was assessed with a 6 min walk test in three modes (in randomized order) with 30 min of rest in between: a control walk with no shell or wrap; a sham CNP in which the applied CNP was negligible; and CNP, with pressure chosen by the patient that provided maximal relief of dyspnea at rest.
RESULTS: At the end of each of the 6 min walk tests, there was no difference in heart rate, oxygen saturation or level of dyspnea among the three test modes. Respiratory rate was reduced with CNP compared with sham. The patients walked furthest with CNP compared with control (mean ± SD) (313 ± 66.2 m versus 257 ± 65.2 m; P<0.01) and compared with sham.
CONCLUSIONS: In the present pilot study, COPD patients improved their exercise performance with CNP.
Authors:
Rakesh K Chaturvedi; Arnold Zidulka
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian respiratory journal : journal of the Canadian Thoracic Society     Volume:  18     ISSN:  1916-7245     ISO Abbreviation:  Can. Respir. J.     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-03-03     Completed Date:  2012-04-10     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  9433332     Medline TA:  Can Respir J     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e6-9     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, Royal Victoria Hospital, Montreal, Quebec.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Exercise Tolerance*
Female
Humans
Male
Middle Aged
Pilot Projects
Pulmonary Disease, Chronic Obstructive / physiopathology,  therapy*
Ventilators, Negative-Pressure*
Comments/Corrections

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