Abstract

MARTINEZ FRAGA, Alejandro et al. Non-invasive ventilation improves the outcome of exercise in COPD patients. Rev. amer. med. respiratoria [online]. 2011, vol.11, n.3, pp.125-133. ISSN 1852-236X.

There are few exercise studies about the effect of bi-level non-invasive ventilation (NIV) on the exercise in COPD patients. The objective of the study was to evaluate the impact of NIV on the results of submaximal and maximal field exercise tests in COPD patients. The COPD patients were selected according to the GOLD definition. The study tests included: the six minute walking test (ATS guidelines), stair climbing test (Girish et al., Chest 2001) and shuttle test (Singh et al., Thorax 1992) which were measured with the Borg scale for legs and dyspnea, arterial saturation and heart rate. With a nasal mask, the NIV was adapted with pressure support ventilation through 15 cm H2O of IPAP and 4 cm H2O of EPAP. Then, the same exercise tests were performed. Eleven COPD patients were evaluated: age (median) 61 years (IC25-75%, 58-75), male sex 72%, FVC: 65% (IC25-75%, 60.1-70); FEV1: 37.4(IC25-75%, 33.97-42.5); FEV1/ FVC: 46 (IC25-75%, 42.5-52.5); PaO2: 68 mmHg (IC25-75%,63-75.3); PaCO2: 40mmHg (IC25-75%, 39-41). The NIV increased the walked distance by 61.78% (p=0.001) and load (kg.m) by 16.55% (p=0.002) in the six minute walking test. There was no significant difference in the symptoms (dyspnea and fatigue) in the Borg scale. The NIV increased the ascent velocity by 11.81% (p=0.05) in the stair climbing test. No significant changes in symptoms and ascended height were observed The NIV increased the walked distance by 30.6% (p=0.001), without significant changes in symptoms. As conclusion, distance increased significantly with NIV in the six minute walking test and shuttle test. A higher velocity was observed in the stair climbing test. This study was the first experience of NIV on the stair climbing test in COPD patients.

Keywords : COPD; Exercise tests; Non invasive ventilation; Six minute walking test; Stair climbing test; Shuttle test.

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