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Increased ventilation with NiIPPV does not necessarily improve exercise capacity in COPD

The Respiratory Support and Sleep Centre, Papworth Hospital, Papworth Everard, Cambridge, UK

CORRESPONDENCE: M.P. Highcock, Respiratory Support and Sleep Centre, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, UK. Fax: 44 1480830620. E-mail: martin.highcock@dbh.nhs.uk

Keywords: chronic obstructive pulmonary disease, exercise test, exhaustive treadmill exercise, noninvasive ventilation, positive-pressure ventilation

Received: November 6, 2001
Accepted February 6, 2002

Evidence that noninvasive intermittent positive-pressure ventilation (NiIPPV) improves exercise capacity in chronic obstructive pulmonary disease (COPD) is limited. The effectiveness of different ventilators in this setting has not been studied.

Three bilevel pressure support ventilators (Bipap S/T 30, Nippy2 and Vpap II ST), applied via a mouthpiece, were compared during submaximal treadmill exercise in eight subjects with COPD. Subjects walked to exhaustion with each of the ventilators and while breathing through the mouthpiece alone, in random order. In addition, four unencumbered walks were performed.

The unencumbered distance (mean±sd) walked was 259±123 m. With the mouthpiece alone this decreased to 211±96 m and fell further to 145±76 m with NiIPPV. There was no difference between the brands of ventilator. At the break-point of exercise, significant increases were seen in tidal volume and minute ventilation in the ventilator walks compared with the mouthpiece alone.

Noninvasive intermittent positive-pressure ventilation increased ventilation but did not improve exercise capacity in the subjects in this study. No significant differences were seen between the ventilators. The effectiveness of this technique and the optimal method of assistance require further clarification.

This article has been cited by other articles:

				M. A. Kolodziej, L. Jensen, B. Rowe, and D. Sin Systematic review of noninvasive positive pressure ventilation in severe stable COPD Eur. Respir. J., August 1, 2007; 30(2): 293 - 306. [Abstract] [Full Text] [PDF]