Early pulmonary rehabilitation increases 6MWD and reduces CRP in hospitalized patients with severe AECOPD

Abstract

Background: Most pulmonary rehabilitation programs(PRP)are often provided to stable COPD patients,but fewer training programs are specific for hospitalized patients with acute exacerbation (AE).Patients with AECOPD experience increased dyspnea sensations and systemic inflammation during exercise training. High-flow nasal therapy(HFNT)reduces the minute volume and the work of breathing.However,it is not clear whether HFNT is efficient during exercise training.In this study,we investigated the effects of HFNT during exercise training in an early PR program among hospitalized patients with severe AECOPD.

Methods: We enrolled AECOPD hospitalized during 48hrs and randomized into two groups according to their status into HFNT PR and non-HFNT PR groups.This study collected basic data,pulmonary function test, 6-min walking distance(6MWD),blood inflammatory biomarkers,and arterial gas analysis at the baseline,4 and12weeks of the intervention.

Result: We recruited 44 AECOPD patients who completed the 12week PR program.The HFNT PRP produced significant improvements in exercise tolerance by the 6MWD,reduced dyspnea sensations in the mMRC,and decreased systemic inflammation as evidenced by the lower CRP level.A reduction in the length of hospitalization was achieved with PR in the 1-year follow-up in the two groups.The HFNT PR group showed better trends of reduced air trapping in the delta inspiration capacity and an increased quality of life according to the CAT score than did the non-HFNT PR group.

Conclusions: HFNT during exercise training in early PR increases exercise tolerance and reduces systemic inflammation in AECOPD.