Effects of non-invasive positive pressure ventilation during treadmill exercise in stable patients with severe chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 YIN Huiming , YU Bin , DAI Youhua , ZHOU Mudan

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Hunan Medical College, Huaihua, Hunan 418000, P. R. China;

Corresponding author：

YIN Huiming, Email: xycf99@21cn.com

Keywords：

Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Noninvasive positive pressure ventilation; Treadmill exercise

DOI：

10.7507/1671-6205.201702020

Video：

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Objective To investigate the effects of mask BiPAP noninvasive positive ventilation (NIPPV) during treadmill exercise on dyspnea index and exercise endurance in stable patients with severe chronic obstructive pulmonary disease (COPD). Methods Twenty inpatients with stable severe COPD between August 2015 and January 2016 were recruited in the study. The following parameters were measured before and after 8-week rehabilitation by NIPPV during treadmill exercises, including 12-minute walking distance (12MWD), Borg dyspnea score, mean pulmonary arterial pressure (mPAP), PaO ₂ and PaCO ₂, times of acute exacerbation in 1 year, adverse reactions, and adherence. Results After rehabilitation for 8 weeks, the following parameters were improved than those before treatment including 12MWD [(810±20) mvs. (680±15) m,P<0.01], Borg dyspnea score (2.4±0.1vs. 4.4±0.3,P<0.01), mPAP [(34.4±2.7) mm Hgvs. (43.5±3.8) mm Hg], PaCO ₂ [(49.8±4.9) mm Hgvs. (64.3±5.2) mm Hg], PaO ₂ [(64.4±4.1) mm Hgvs. (52.3±3.9) mm Hg] and the times of acute exacerbation (2.1±0.7vs. 4.3±2.1,P<0.01). Adverse reactions included oropharyngeal drying (2 cases) and gaseous distention (8 cases) which can be tolerated without special treatment. Conclusion Mask NIPPV during treadmill exercise is safe and effective for stable patients with severe COPD and worthy of clinical application.

Citation： YIN Huiming, YU Bin, DAI Youhua, ZHOU Mudan. Effects of non-invasive positive pressure ventilation during treadmill exercise in stable patients with severe chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(5): 432-435. doi: 10.7507/1671-6205.201702020 Copy

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12.	Mador MJ, Rodis A, Magaiang UJ. Reproducibility of berg scale measurement of dyspnoea during exercise in patients with COPD. Chest, 1995, 107(6): 1590-1597.
13.	Bambi S. Noninvasive positive pressure ventilation: an ABC approach for advanced nursing in emergency departments and acute care settings. Dimens Crit Care Nuts, 2009, 28(6): 253-263.
14.	Bianchi L, Foglio K, Porta R.et al.Lack of additional effect of adjunct of assisted ventilation to pulmonary rehabilitation in mild COPD patients. Respir Med, 2002, 96(5):359-367.
15.	李群, 陈锋, 王晓霞, 等. 肺康复训练对不同严重度稳定期慢性阻塞性肺疾病的影响. 中国呼吸与危重监护杂志, 2013, 12(2): 130-135.0.
16.	孟志刚, 佘瑞芳, 姚彬. 持续肺康复训练对保持 COPD 患者肺康复治疗后运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2010, 9(2): 133-136.0.
17.	孙楷, 聂洪玉, 刘泳,等. 肺康复对慢性阻塞性肺疾病患者运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2014, 13(5): 459-463.0.
18.	Carolyn L. Rochester, Ioannis Vogiatzis, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med, 2015, 192(11), 1373-1386.
19.	Costes F, Agresti A, Court-Fortune I, et al. Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease. Cardiopulm Rehabil, 2003, 23(4): 307-313.

1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease revised 2015. Available at http://www.Gold-copd.org/guidelines-global-strategy-for-diagnosis-management.
2. Rabe KF, Hurd S, Anzueto A, et al. Global Initiative for Chronic Obstructive Lung Disease Global strategy for the diagnosis, management, and prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) executive summary. Am J Respir Crit Care Med, 2007, 176(6): 532-555.
3. Gershon A, Warner L, Cascagnette P, et al. Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study. Lancet, 2011, 378(9795): 991-996.
4. 乔翠霞, 李素云. 慢性阻塞性肺疾病的流行病学研究现状. 中国老年学杂志, 2010, 30(11): 1618-1621.0.
5. Nici L, Donner C, Wouters E, et al. ATS/ERS Pulmonary Rehabilitation Writing Committee. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med, 2006, 173(12): 1390-1413.
6. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-e64.
7. Dreher M, Waherspacher S, Sonntag F, et al. Exercise in severe COPD: is walking different from stair-climbing. Respir Med, 2008, 102(6):912-918.
8. Borghi-Silva A, Mendes RG, Toledo AC, et al. Adjuncts to physical training of patients with severe COPD: oxygen or noninvasive ventilation? Respir Care, 2010, 55(7):885-894.
9. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4).1-12.0.
10. Corner E, Garred R. Does the addition of non-invasive ventilation during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease augment patient outcome in exercise tolerance? A literature review. Physiother Res Int, 2010, 15(1):5-15.
11. Mc Gavin CR, Gupta SP, Mc Hardy GJ. Twelve-minutes walking test for assessing disability in chronic bronchitis. Br Med J, 1976, 1(6013): 822-823.
12. Mador MJ, Rodis A, Magaiang UJ. Reproducibility of berg scale measurement of dyspnoea during exercise in patients with COPD. Chest, 1995, 107(6): 1590-1597.
13. Bambi S. Noninvasive positive pressure ventilation: an ABC approach for advanced nursing in emergency departments and acute care settings. Dimens Crit Care Nuts, 2009, 28(6): 253-263.
14. Bianchi L, Foglio K, Porta R.et al.Lack of additional effect of adjunct of assisted ventilation to pulmonary rehabilitation in mild COPD patients. Respir Med, 2002, 96(5):359-367.
15. 李群, 陈锋, 王晓霞, 等. 肺康复训练对不同严重度稳定期慢性阻塞性肺疾病的影响. 中国呼吸与危重监护杂志, 2013, 12(2): 130-135.0.
16. 孟志刚, 佘瑞芳, 姚彬. 持续肺康复训练对保持 COPD 患者肺康复治疗后运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2010, 9(2): 133-136.0.
17. 孙楷, 聂洪玉, 刘泳,等. 肺康复对慢性阻塞性肺疾病患者运动能力和生活质量的影响. 中国呼吸与危重监护杂志, 2014, 13(5): 459-463.0.
18. Carolyn L. Rochester, Ioannis Vogiatzis, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med, 2015, 192(11), 1373-1386.
19. Costes F, Agresti A, Court-Fortune I, et al. Noninvasive ventilation during exercise training improves exercise tolerance in patients with chronic obstructive pulmonary disease. Cardiopulm Rehabil, 2003, 23(4): 307-313.

Chinese Journal of Respiratory and Critical Care Medicine

Effects of non-invasive positive pressure ventilation during treadmill exercise in stable patients with severe chronic obstructive pulmonary disease

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