• Am. J. Med. Sci. · Aug 2023

    Letter Randomized Controlled Trial

    Non-invasive ventilatory support accelerates the oxygen uptake and heart rate kinetics and improves muscle oxygenation dynamics in COPD-HF patients.

    • Rodrigo Polaquini Simões, Cássia da Luz Goulart, Flávia Rossi Caruso, de AraújoAdriana S GarciaASGCardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil., de MouraSílvia Cristina GarciaSCGCardiovascular Physical Therapy Laboratory, Physiotherapy Department, Federal University of São Carlos, Sao Carlos, SP, Brazil., Aparecida Maria Catai, Polliana Batista Dos Santos, Patricia de Faria Camargo, Renan Shida Marinho, Renata Gonçalves Mendes, and Audrey Borghi-Silva.
    • Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil.
    • Am. J. Med. Sci. 2023 Aug 1; 366 (2): 124134124-134.

    BackgroundThe aim of this study was to explore the effects of non-invasive positive pressure ventilation (NIPPV) associated with high-intensity exercise on heart rate (HR) and oxygen uptake (V̇O2) recovery kinetics in in patients with coexistence of chronic obstructive pulmonary disease (COPD) and heart failure (HF).MethodsThis is a randomized, double blinded, sham-controlled study involving 14 HF-COPD patients, who underwent a lung function test and Doppler echocardiography. On two different days, patients performed incremental cardiopulmonary exercise testing (CPET) and two constant-work rate tests (80% of CPET peak) receiving Sham or NIPPV (bilevel mode - Astral 150) in a random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin and deoxyhemoglobin were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, Netherland).ResultsThe kinetic variables of both V̇O2 and HR during the high-intensity constant workload protocol were significantly faster in the NIPPV protocol compared to Sham ventilation (P < 0.05). Also, there was a marked improvement in oxygenation and lower deoxygenation of both peripheral and respiratory musculature in TLim during NIPPV when contrasted with Sham ventilation.ConclusionsNIPPV applied during high-intensity dynamic exercise can effectively improve exercise tolerance, accelerate HR and V̇O2 kinetics, improve respiratory and peripheral muscle oxygenation in COPD-HF patients. These beneficial results from the effects of NIPPV may provide evidence and a basis for high-intensity physical training for these patients in cardiopulmonary rehabilitation programs.Copyright © 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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