COPD
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Randomized Controlled Trial
Walking with Non-Invasive Ventilation Does Not Prevent Exercise-Induced Hypoxaemia in Stable Hypercapnic COPD Patients.
Non-invasive positive pressure ventilation (NPPV) in addition to supplemental oxygen improves arterial oxygenation, walking distance and dyspnea when applied during exercise in stable hypercapnic COPD patients. The aim of the current study was to investigate whether NPPV without supplemental oxygen is capable of preventing severe exercise-induced hypoxemia in these patients when applied during walking. ⋯ The use of NPPV during walking without the application of supplemental oxygen does not prevent exercise-induced hypoxemia in patients with stable hypercapnic COPD.
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Randomized Controlled Trial
Exercise endurance in chronic obstructive pulmonary disease patients at an altitude of 2640 meters breathing air and oxygen (FIO2 28% and 35%): a randomized crossover trial.
At Bogota's altitude (2640 m), the lower barometric pressure (560 mmHg) causes severe hypoxemia in COPD patients, limiting their exercise capacity. The aim was to compare the effects of breathing oxygen on exercise tolerance. ⋯ Oxygen administration for COPD patients in Bogotá significantly increased ET by decreased respiratory load, improved cardiovascular performance and oxygen transport. The higher increases of the PaO2 and SaO2 with 35% FIO2 did not represent a significant advantage in the ET. This finding has important logistic and economic implications for oxygen use in rehabilitation programs of COPD patients at the altitude of Bogotá and similar altitudes.
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Randomized Controlled Trial
Efficacy of low molecular weight heparin in patients with acute exacerbation of chronic obstructive pulmonary disease receiving ventilatory support.
Severe and acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with a high mortality. Since COPD is an airway inflammatory disease, and heparin has shown anti-inflammatory effects in previous studies, we evaluated the clinical effect of low molecular weight heparin (LMWH; nadroparin) in COPD patients admitted into the hospital due to acute exacerbations. ⋯ The addition of LMWH to standard therapy benefits COPD patients with acute exacerbation.
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Randomized Controlled Trial Comparative Study
Comparing dynamic hyperinflation and associated dyspnea induced by metronome-paced tachypnea versus incremental exercise.
Dynamic hyperinflation (DH) during exercise is associated with both dyspnea and exercise limitation in COPD. Metronome-paced tachypnoea (MPT) is a simple alternative for studying DH. We compared MPT with exercise testing (XT) as methods of provoking DH, and assessed their relationship with dyspnea. ⋯ Although greater during XT, the intensity of dyspnea bore no relationship to DH during either MPT and XT. MPT at 40 breaths/min and I:E of 1:1 elicits the greatest ∆IC, and is a more sensitive method for demonstrating DH. The relationship between DH and dyspnea is complex and not determined by DH alone.
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Randomized Controlled Trial
Severe chronic bronchitis in advanced emphysema increases mortality and hospitalizations.
Chronic bronchitis in COPD has been associated with an increased exacerbation rate, more hospitalizations, and an accelerated decline in lung function. The clinical characteristics of patients with advanced emphysema and chronic bronchitis have not been well described. ⋯ Severe chronic bronchitis is associated with worse survival, shorter time to hospitalization, and worse health-related quality of life.