During exercise non-invasive ventilation in chronic restrictive respiratory failure - 08/08/11
, Bernard Wuyam b, c, Nathalie Chouri-Pontarollo c, Chrystèle Deschaux c, Patrick Levy a, c, Jean-Louis Pépin a, c
Corresponding author at: Laboratoire EFCR, CHU de Grenoble, BP217X 38043, Grenoble cedex 09, Grenoble, France. Tel.: +33476765516; fax: +33476765586.Summary |
Background |
Exercise intolerance limits chronic restrictive respiratory failure (CRF) patients from participating in daily activities. The specific modalities that could improve exercise tolerance in these patients remain to be established.
Objective |
To investigate exercise endurance and associated physiological responses with non-invasive ventilation (NIV) during exercise in restrictive CRF patients.
Methods |
Eighteen patients (63±11 years, total lung capacity (TLC)=59±16% of predicted value) performed maximal exercise in spontaneous breathing conditions (MWLE) and during two constant workload exercise (CWLE) tests at 75% Pmax, with or without NIV in random order. “NIV Responders” were defined by an increase in CWLE duration of more than 50% when using NIV.
Results |
For the whole group, CWLE duration when using NIV increased from 5.6±4.6 to 9.6±8.1min. Increase in CWLE duration correlated with reduction in heart rate and oxygen desaturation, and dyspnea relief during exercise. NIV responders (n=9) showed more severe lung restriction (TLC: 2.6±0.7 versus 3.5±1.1L; forced vital capacity: 1.0±0.16 versus 1.46±0.38L). At the end of MWLE, responders had a lower Vt (0.60±0.09 versus 0.89±0.34L), a higher dead-space ratio (0.51±0.06 versus 0.38±0.12) and lower oxygen pulse (4.5±1.2 versus 7.4±3.9ml/beat).
Conclusion |
In severely restrictive patients, NIV during exercise significantly improved exercise duration and tolerance and increased alveolar ventilation.
Trial registration |
The enrollment of the patients started before July 1, 2005.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic restrictive respiratory failure, Exercise, Non-invasive ventilation, Kyphoscoliosis, Respiratory function
Plan
Vol 102 - N° 5
P. 711-719 - mai 2008 Retour au numéro
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