Chest
Clinical InvestigationsPOSITIVE PRESSUREEffects of Training With Heliox and Noninvasive Positive Pressure Ventilation on Exercise Ability in Patients With Severe COPD
Section snippets
Study Population
All patients referred to the comprehensive pulmonary rehabilitation program during the period from March 1, 1996, to January 31, 1997, were considered for the study. Patients were referred from their pulmonologist or primary health-care provider from the population of military beneficiaries in the San Antonio, TX metropolitan area. The inclusion criteria were a diagnosis of COPD, an FEV1 < 50% of predicted, and the ability to walk on a treadmill. Patients were excluded if they had exertional
Results
Forty-one patients were enrolled in the pulmonary rehabilitation program during the study period. Two patients were excluded because of a primary diagnosis of interstitial lung disease. Thirty-nine patients entered the study, and 32 patients completed the entire program. Seven patients dropped out, one each for exertional angina, congestive heart failure, a flare of chronic liver disease, a COPD exacerbation, a tibial fracture, a scheduling conflict, and noncompliance. Of these, four patients
Discussion
This study answered some questions but not others. The two primary questions were whether heliox or NIPPV treatment produces an immediate improvement in exercise capability in patients with COPD, and whether exercising with the assistance of these modalities produces a greater training effect than exercising unassisted. We chose to use individualized treadmill tests to produce our end points. Considerable variability has been documented in how exercise testing is performed between pulmonary
Conclusion
Heliox administered in the fashion described offers no immediate or training benefits for patients with COPD. NIPPV administered as an IPAP of 8 to 12 cm H2O does confer an immediate benefit in terms of both exercise duration and maximum workload for patients trained on it. Whether NIPPV enhances exercise reconditioning enough to have a demonstrable effect that carries over to unassisted exercise is still uncertain. It seems intuitive that the increased exercise capability with NIPPV should
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Is helium beneficial in a pulmonary rehabilitation program for severe COPD?
2022, Revue des Maladies RespiratoiresNon-invasive ventilation intervention during exercise training in individuals with chronic obstructive pulmonary disease: A systematic review and meta-analysis
2021, Annals of Physical and Rehabilitation MedicineCitation Excerpt :The other 3 studies used different exercise test programs: exercise time, maximum workload [14], shuttle walking distance, cycle endurance [15], and incremental cycle test [16]. Johnson et al. [14] evaluated the effect of NIV for individuals who underwent regular exercise conditioning. Use of the ventilator produced an immediate improvement in both exercise time and maximum workload.
Noninvasive ventilation during pulmonary rehabilitation in COPD patients
2016, Revue des Maladies RespiratoiresStrategies to enhance the benefits of exercise training in the respiratory patient
2014, Clinics in Chest MedicineContrasting breathing retraining and helium-oxygen during pulmonary rehabilitation in COPD: A randomized clinical trial
2014, Respiratory MedicineCitation Excerpt :The result is an acute increase in exercise tolerance in selected patients with COPD [8,9]. Combining heliox breathing with exercise training has given inconsistent results [18–20]. Johnson et al. [20] reported no advantage in using heliox during exercise training in patients with COPD.
The opinions or assertions contained herein are the private views of the authors and should not be construed as reflecting the views of the Department of the Army or the Department of Defense.
Funded completely through Brooke Army Medical Center local research funds.