Helium-Hyperoxia, Exercise, and Respiratory Mechanics in Chronic Obstructive Pulmonary Disease

Eves, Neil D.; Petersen, Stewart R.; Haykowsky, Mark J.; Wong, Eric; Jones, Richard L.

doi:10.1164/rccm.200509-1533oc

Cited by 113 publications

(110 citation statements)

References 34 publications

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“…As a result of their decreased density, heliumcontaining gas mixtures reduce the resistance to airflow, which in turn may decrease the work of breathing, reduce the severity of hyperinflation, increase exercise capacity, and decrease dyspnea in patients with obstructive lung disease (231)(232)(233). A single study suggests a beneficial effect in patients with lung cancer, although all the patients in the study had coexistent airflow obstruction (234).…”

Section: Treatmentmentioning

confidence: 98%

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,500

1,328

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Section: Treatmentmentioning

confidence: 98%

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,500

1,328

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“…Indeed, dynamic hyperinflation correlates very closely with reduced exercise tolerance [3] and therapies that decrease dynamic hyperinflation, such as bronchodilators [6] and supplemental oxygen [2], significantly improve exercise tolerance in many patients. Heliox (79% helium, 21% oxygen), through its effect of increasing expiratory flow rate [7], has also been shown to increase exercise tolerance time [8][9][10] by delaying dynamic hyperinflation in COPD patients [9].…”

mentioning

confidence: 99%

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Butcher

Lagerquist²,

Marciniuk³

et al. 2008

Eur Respir J

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Dynamic hyperinflation and leg muscle fatigue are independently associated with exercise limitation in patients with chronic obstructive pulmonary disease (COPD). The aims of the present study were to examine 1) the relationship between these limitations and 2) the effect of delaying ventilatory limitation on exercise tolerance and leg muscle fatigue.In total, 11 patients with COPD (with a forced expiratory volume in one second of 52% predicted) completed two cycling bouts breathing either room air or heliox, and one bout breathing heliox but stopping at room air isotime. End-expiratory lung volume (EELV), leg muscle fatigue and exercise time were measured.On room air, end-exercise EELV was negatively correlated with leg fatigue. Heliox increased exercise time (from 346 to 530 s) and leg fatigue (by 15%). At isotime, there was no change in leg fatigue, despite a reduction in EELV compared with end-exercise, in both room air and heliox. The change in exercise time with heliox was best correlated with room air leg fatigue and endinspiratory lung volume.Patients with chronic obstructive pulmonary disease who had greater levels of dynamic hyperinflation on room air had less muscle fatigue. These patients were more likely to increase exercise tolerance with heliox, which resulted in greater leg muscle fatigue.

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“…The observed relief of exertional dyspnoea with oxygen supplementation during exercise is associated with a suppression of the ventilatory drive and reduced blood lactate levels [76]. Recently, helium hyperoxia mixtures (heliox; 40% O 2 , 60% He) have been found to significantly reduce work of breathing and dyspnoea during exercise [77]. The helium component improves dynamic hyperinflation, leading to a greater increase in exercise endurance than with hyperoxia alone.…”

Section: Reduction Of Ventilatory Requirements and Work Of Breathingmentioning

confidence: 99%

Rehabilitation and acute exacerbations

Burtin¹,

Decramer²,

Gosselink³

et al. 2011

Eur Respir J

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Recent evidence indicates that acute exacerbations of chronic obstructive pulmonary disease aggravate the extrapulmonary consequences of the disease. Skeletal muscle dysfunction, a sustained decrease in exercise tolerance, enhanced symptoms of depression and fatigue are reported. Avoidance of physical activities is likely to be a key underlying mechanism and increases the risk of new exacerbations. Pulmonary rehabilitation is an intervention targeting these systemic consequences. Exercise strategies need to be adapted to the increased feelings of dyspnoea and fatigue.This review aims to describe the systemic consequences of acute exacerbations and compiles evidence for the feasibility and effectiveness of different rehabilitation strategies to counteract these consequences during and/or immediately after the acute phase of the exacerbation. Resistance training and neuromuscular electrical stimulation have been applied safely in frail, hospitalised patients and have the potential to prevent muscle atrophy. Comprehensive pulmonary rehabilitation, including general exercise training, can be implemented immediately after the exacerbation, leading to a reduction in hospital admissions and an increase in exercise tolerance and quality of life. Self-management strategies play a crucial role in changing diseaserelated health behaviour and preventing hospital admissions.

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Helium-Hyperoxia, Exercise, and Respiratory Mechanics in Chronic Obstructive Pulmonary Disease

Abstract: Combining helium and hyperoxia delays dynamic hyperinflation and improves respiratory mechanics, which translates into added improvements in exercise tolerance for patients with COPD.

Cited by 113 publications

References 34 publications

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Rehabilitation and acute exacerbations

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