Bilevel Noninvasive Ventilation During Exercise Reduces Dynamic Hyperinflation and Improves Cycle Endurance Time in Severe to Very Severe COPD

Dennis, C.; Menadue, Collette; Schneeberger, Tessa; Leitl, Daniela; Schoenheit‐Kenn, Ursula; Hoyos, Camilla M.; Harmer, Alison R.; Barnes, David; Koczulla, Andreas Rembert; Kenn, Klaus; Alison, Jennifer A.

doi:10.1016/j.chest.2021.06.050

Cited by 14 publications

(9 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Different training modalities can allow people with high symptom burden to train at higher intensities, for longer, or more consistently. These include interval training ( 53 ), partitioned training (e.g., single-leg raises or cycling [ 54 ]), use of noninvasive ventilation ( 55 , 56 ), and neuromuscular electrical stimulation ( 57 , 58 ), which reduce the load on the respiratory system and improve exercise tolerance ( 59 ). Given the fluctuations in symptom burden and function experienced in the context of frailty ( 30 ), regular assessment of exercise tolerance and progression as individuals continue through their programs remains important.…”

Section: Implications Of Frailty On Rehabilitation Program Contentmentioning

confidence: 99%

Rehabilitation for People with Respiratory Disease and Frailty: An Official American Thoracic Society Workshop Report

Maddocks¹,

Brighton²,

Alison³

et al. 2023

Annals ATS

Self Cite

View full text Add to dashboard Cite

People with respiratory disease have increased risk of developing frailty, which is associated with worse health outcomes. There is growing evidence of the role of rehabilitation in managing frailty in people with respiratory disease. However, several challenges remain regarding optimal methods of identifying frailty and delivering rehabilitation for this population. The aims of this American Thoracic Society workshop were to outline key definitions and concepts around rehabilitation for people with respiratory disease and frailty, synthesize available evidence, and explore how programs may be adapted to align to the needs and experiences of this population. Across two half-day virtual workshops, 20 professionals from diverse disciplines, professions, and countries discussed key developments and identified opportunities for future research, with additional input via online correspondence. Participants highlighted a “frailty rehabilitation paradox” whereby pulmonary rehabilitation can effectively reduce frailty, but programs are challenging for some individuals with frailty to complete. Frailty should not limit access to rehabilitation; instead, the identification of frailty should prompt comprehensive assessment and tailored support, including onward referral for additional specialist input. Exercise prescriptions that explicitly consider symptom burden and comorbidities, integration of additional geriatric or palliative care expertise, and/or preemptive planning for disruptions to participation may support engagement and outcomes. To identify and measure frailty in people with respiratory disease, tools should be selected on the basis of sensitivity, specificity, responsiveness, and feasibility for their intended purpose. Research is required to expand understanding beyond the physical dimensions of frailty and to explore the merits and limitations of telerehabilitation or home-based pulmonary rehabilitation for people with chronic respiratory disease and frailty.

show abstract

Section: Implications Of Frailty On Rehabilitation Program Contentmentioning

confidence: 99%

Rehabilitation for People with Respiratory Disease and Frailty: An Official American Thoracic Society Workshop Report

Maddocks¹,

Brighton²,

Alison³

et al. 2023

Annals ATS

Self Cite

View full text Add to dashboard Cite

show abstract

“…A greater physiological response is achieved with training at high intensity, but patients with severe COPD are often incapable of achieving these high intensities due to dynamic hyperinflation and hypoxaemia, resulting in early lactatemia 16 . Potential mechanisms by which NIV might improve exercise tolerance are respiratory muscle unloading, improving oxygenation due to better ventilation-perfusion ratio and reducing hyperinflation 16 17 . A recent meta-analysis included 15 randomized controlled trials (RCTs), which studied the effect of NIV during a training exercise programme of 4–12 weeks 18▪ , and concluded that after the training programme, the 6-min walking distance was higher in the group that trained with NIV and experienced lower fatigue during NIV use.…”

Section: Non-invasive Ventilation During Exercise For Symptom Reliefmentioning

confidence: 99%

Home ventilation for patients with end-stage chronic obstructive pulmonary disease

Raveling,

Rantala,

Duiverman

2023

Current Opinion in Supportive &Amp; Palliative Care

View full text Add to dashboard Cite

Purpose of the review The number of patients with end-stage chronic obstructive pulmonary disease (COPD) treated with chronic non-invasive ventilation (NIV) has greatly increased. In this review, the authors summarize the evidence for nocturnal NIV and NIV during exercise. The authors discuss the multidisciplinary and advanced care of patients with end-stage COPD treated with NIV. Recent findings Nocturnal NIV improves gas exchange, health-related quality of life and survival in stable hypercapnic COPD patients. Improvements in care delivery have been achieved by relocating care from the hospital to home based; home initiation of chronic NIV is feasible, non-inferior regarding efficacy and cost-effective compared to in-hospital initiation. However, the effect of NIV on symptoms is variable, and applying optimal NIV for end-stage COPD is complex. While exercise-induced dyspnoea is a prominent complaint in end-stage COPD, nocturnal NIV will not change this. However, NIV applied solely during exercise might improve exercise tolerance and dyspnoea. While chronic NIV is often a long-standing treatment, patient expectations should be discussed early and be managed continuously during the treatment. Further, integration of advance care planning requires a multidisciplinary approach. Summary Although chronic NIV is an effective treatment in end-stage COPD with persistent hypercapnia, there are still important questions that need to be answered to improve care of these severely ill patients.

show abstract

“…Garrod and colleagues report that the use of NPPV as an adjunct to exercise training in COPD patients can help improve exercise tolerance and health status ( Garrod et al, 2000 ). Non-invasive ventilation can reduce hyperinflation ( Dennis et al, 2021 ).The main objective of NPPV in patients with severe COPD is to improve gas exchange and to provide adequate rest for the respiratory muscles after periods of fatigue ( García et al, 2011 ). NPPV assists the diaphragm in respiratory movements, which helps to relieve the burden on the diaphragm, reduce respiratory work and promote the recovery of diaphragmatic dysfunction ( Duiverman et al, 2016 ).…”

Section: Rehabilitation Treatment Of Diaphragm Dysfunction In Copdmentioning

confidence: 99%

Diaphragm Dysfunction and Rehabilitation Strategy in Patients With Chronic Obstructive Pulmonary Disease

Cao

Wang

et al. 2022

Front. Physiol.

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) affects the whole body and causes many extrapulmonary adverse effects, amongst which diaphragm dysfunction is one of the prominent manifestations. Diaphragm dysfunction in patients with COPD is manifested as structural changes, such as diaphragm atrophy, single-fibre dysfunction, sarcomere injury and fibre type transformation, and functional changes such as muscle strength decline, endurance change, diaphragm fatigue, decreased diaphragm mobility, etc. Diaphragm dysfunction directly affects the respiratory efficiency of patients and is one of the important pathological mechanisms leading to progressive exacerbation of COPD and respiratory failure, which is closely related to disease mortality. At present, the possible mechanisms of diaphragm dysfunction in patients with COPD include systemic inflammation, oxidative stress, hyperinflation, chronic hypoxia and malnutrition. However, the specific mechanism of diaphragm dysfunction in COPD is still unclear, which, to some extent, increases the difficulty of treatment and rehabilitation. Therefore, on the basis of the review of changes in the structure and function of COPD diaphragm, the potential mechanism of diaphragm dysfunction in COPD was discussed, the current effective rehabilitation methods were also summarised in this paper. In order to provide direction reference and new ideas for the mechanism research and rehabilitation treatment of diaphragm dysfunction in COPD.

show abstract

Bilevel Noninvasive Ventilation During Exercise Reduces Dynamic Hyperinflation and Improves Cycle Endurance Time in Severe to Very Severe COPD

Cited by 14 publications

References 37 publications

Rehabilitation for People with Respiratory Disease and Frailty: An Official American Thoracic Society Workshop Report

Rehabilitation for People with Respiratory Disease and Frailty: An Official American Thoracic Society Workshop Report

Home ventilation for patients with end-stage chronic obstructive pulmonary disease

Diaphragm Dysfunction and Rehabilitation Strategy in Patients With Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About