Respiratory care
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Randomized Controlled Trial
Noninvasive Ventilation as an Important Adjunct to an Exercise Training Program in Subjects With Moderate to Severe COPD.
The primary objective of this study was to investigate whether noninvasive ventilation (NIV) can positively affect exercise capacity, maximum oxygen uptake (V̇O2 ), and symptoms after a 6-week physical training program for subjects with moderate to very severe COPD. ⋯ A 6-week physical training program alone can improve tolerance for exercise and quality of life, in addition to reducing the risk of mortality. However, NIV associated with a physical training program was shown to have an additive beneficial effect on powerful prognostic markers (maximum V̇O2 and circulatory power) and to reduce symptoms and improve oxygen saturation in subjects with moderate to very severe COPD.
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Randomized Controlled Trial Comparative Study
Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation.
Predosing patients with COPD with salbutamol by using a pressurized metered-dose-inhaler (pMDI) as a bronchodilator was hypothesized to improve the distribution of the subsequent nebulized dose. This study determined the effect of a pMDI preliminary bronchodilator dose on the aerosol delivered by a mesh nebulizer during single-limb noninvasive ventilation. ⋯ The T-piece and large spacer were equally efficient for salbutamol delivery from the mesh nebulizer in patients with COPD and on single-limb noninvasive ventilation. Adding a preliminary bronchodilator dose by pMDI prenebulization showed a trend toward greater pulmonary bioavailability of nebulized salbutamol and may be worth considering to maximize delivery of salbutamol to patients who are severely ill.