Nasal high flow does not improve exercise tolerance in COPD patients recovering from acute exacerbation: A randomized crossover study

Respirology ◽  
2019 ◽  
Vol 24 (11) ◽  
pp. 1088-1094 ◽  
Author(s):  
Guillaume Prieur ◽  
Clement Medrinal ◽  
Yann Combret ◽  
Elise Dupuis Lozeron ◽  
Tristan Bonnevie ◽  
...  
2021 ◽  
Vol 180 ◽  
pp. 106354
Author(s):  
Matthew R. Lammi ◽  
Mohamed A. Ghonim ◽  
Jessica Johnson ◽  
Johnny D'Aquin ◽  
John B. Zamjahn ◽  
...  

2014 ◽  
Vol 40 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Maria Enedina Aquino Scuarcialupi ◽  
Danilo Cortozi Berton ◽  
Priscila Kessar Cordoni ◽  
Selma Denis Squassoni ◽  
Elie Fiss ◽  
...  

OBJECTIVE: To investigate the modulatory effects that dynamic hyperinflation (DH), defined as a reduction in inspiratory capacity (IC), has on exercise tolerance after bronchodilator in patients with COPD. METHODS: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometry and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed ΔIC(peak-rest) < 0 were considered to present with DH (DH+). RESULTS: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without DH (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher ΔIC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to ΔIC at peak exercise between DH+ and DH- groups (0.19 ± 0.17 L vs. 0.17 ± 0.15 L, p > 0.05). In addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60%] vs. 10% [3-53%]; p > 0.05). CONCLUSIONS: Improvement in TLim was associated with an increase in IC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.


2020 ◽  
Vol 58 (4) ◽  
pp. 717
Author(s):  
Yamaguchi Keishi ◽  
T. Doi ◽  
T. Muguruma ◽  
K. Nakajima ◽  
K. Nakamura ◽  
...  

2015 ◽  
Vol 9 (2) ◽  
pp. 65-71
Author(s):  
Mohammad Nesar Uddin Ahmed ◽  
Shelina Begum ◽  
Taskina Ali

Background: Pulmonary rehabilitation (PR) is known to be therapeutically useful for COPD patients. Objective: To evaluate the effects of combination of breathing exercises (pursed lip breathing and diaphragmatic breathing) and lower extremity endurance training (LEET) as part of PR program on six minute walk distance (6MWD), on oxygen saturation (SpO2%), on the level of dyspnea and fatigue in patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department (OPD) of the Department of Medicine of BSMMU and NIDCH Dhaka. 56 patients without PR constituted control group and experimental group included 60 patients intervened with PR. The experimental patients were advised to perform the PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. The control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of exercise tolerance, 6MWD, SpO2%, the level of dyspnea and fatigue of all subjects were recorded on day 0 and day 60 for both the groups. SpO2% was recorded by portable Pulse Oximeter and the level of dyspnea as well as fatigue were recorded by Modified Borg Scale. Statistical analysis was done by independent sample ‘t’ test and paired sample ‘t’ test. Results: Significant improvement were observed in 6MWD, SpO2%, the level of dyspnea and fatigue in patients who performed PR program. In addition, significant improvement in these parameters were observed after completing PR program compared to the beginning of the intervention. Conclusion: The study concludes that regular exercise of all components of PR program significantly improve exercise tolerance in COPD patients DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22799 Bangladesh Soc Physiol. 2014, December; 9(2): 65-71


2020 ◽  
Vol 19 (2) ◽  
pp. 76-82
Author(s):  
Lasse Paludan Bentsen ◽  
◽  
Annmarie Touborg Lassen ◽  
Ingrid Louise Titlestad ◽  
Mikkel Brabrand ◽  
...  

Background: The aim of this study was to investigate 30-day mortality for COPD patients treated by ambulances in the period before and after implementation of a pre-hospital oxygen protocol. Methods: Prehospital High-flow oxygen was used from April to September 2012 and titrated oxygen from April to September 2013. Primary outcome was 30-day mortality. Results: 707 patients were included; 209 in the high-flow group and 498 in the titration group. Of these, 56 and 132 arrived with acute exacerbation (AE). Overall 30-day mortality was 11.5% vs. 9.4% (p=0.41), respectively. For patients with AE, it was 19.6% vs. 4.6% (p=0.001). Conclusion: Change of treatment protocol is associated with a lower 30-day mortality for patients registered with acute exacerbation, but not for all COPD patients.


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