Abstract
Background: Intermittent use of pNIV (providing fixed IPAP (18 cmH2O) and EPAP (8 cmH2O)) facilitates more rapid recovery from exercise-induced dynamic hyperinflation (DH) and breathlessness compared to pursed lip breathing (PLB) in COPD.
Methods: In 11 patients with COPD (FEV1: 63±3% predicted) we assessed thoracoabdominal volumes using optoelectronic plethysmography and Borg breathlessness following 1-min application of pNIV (VitaBreath, Philips Respironics) or PLB in recovery from intermittent exercise sustained at 80%WRpeak for 2-min alternated with 2-min of recovery.
Results: Exercise induced consistent levels of end-expiratory thoracoabdominal DH (by 314±41 ml). Compared to the end of exercise, acute 1-min application of pNIV increased end-inspiratory rib cage volume (by 160±88 ml) and decreased end-expiratory rib cage volume (EEVrc: by 146±167 ml); both inspiratory and expiratory flow rates were increased by acute pNIV application compared to PLB (by 0.3±0.1 and 0.2±0.1 l/sec, respectively). In the 2nd min of recovery following pNIV or PLB application, EEVrc was reduced more with pNIV (256±105 ml) compared to PLB (102±67 ml) indicating lower rib cage DH. Furthermore, end-expiratory abdominal volume 2-min into recovery was reduced more with pNIV (241±119 ml) than PLB (94±59 ml) indicating reduced abdominal muscle recruitment. Breathlessness was lower with pNIV (2.8±0.4) compared to PLB (3.5±0.4).
Conclusions: Intermittent application of pNIV during exercise has an effect primarily on rib cage DH. This finding in association with improved inspiratory and expiratory flow rates with pNIV application is reflected by reduced breathlessness in patients with COPD.
Methods: In 11 patients with COPD (FEV1: 63±3% predicted) we assessed thoracoabdominal volumes using optoelectronic plethysmography and Borg breathlessness following 1-min application of pNIV (VitaBreath, Philips Respironics) or PLB in recovery from intermittent exercise sustained at 80%WRpeak for 2-min alternated with 2-min of recovery.
Results: Exercise induced consistent levels of end-expiratory thoracoabdominal DH (by 314±41 ml). Compared to the end of exercise, acute 1-min application of pNIV increased end-inspiratory rib cage volume (by 160±88 ml) and decreased end-expiratory rib cage volume (EEVrc: by 146±167 ml); both inspiratory and expiratory flow rates were increased by acute pNIV application compared to PLB (by 0.3±0.1 and 0.2±0.1 l/sec, respectively). In the 2nd min of recovery following pNIV or PLB application, EEVrc was reduced more with pNIV (256±105 ml) compared to PLB (102±67 ml) indicating lower rib cage DH. Furthermore, end-expiratory abdominal volume 2-min into recovery was reduced more with pNIV (241±119 ml) than PLB (94±59 ml) indicating reduced abdominal muscle recruitment. Breathlessness was lower with pNIV (2.8±0.4) compared to PLB (3.5±0.4).
Conclusions: Intermittent application of pNIV during exercise has an effect primarily on rib cage DH. This finding in association with improved inspiratory and expiratory flow rates with pNIV application is reflected by reduced breathlessness in patients with COPD.
| Original language | English |
|---|---|
| Article number | 2129 |
| Journal | European Respiratory Journal |
| Volume | 56 |
| Issue number | Suppl. 64 |
| DOIs | |
| Publication status | Published - 1 Sept 2020 |
| Event | ERS International Congress 2020 - Online Duration: 6 Sept 2020 → 9 Sept 2020 https://www.ersnet.org/news-and-features/news/ers-international-congress-2020-facts-figures-and-achievements/ |