Respirology : official journal of the Asian Pacific Society of Respirology
-
Randomized Controlled Trial
Haemodynamic effects of proportional assist ventilation during high-intensity exercise in patients with chronic obstructive pulmonary disease.
Proportional assist ventilation (PAV) has been proposed as a more physiological modality of non-invasive ventilation, thereby reducing the potential for deleterious cardio-circulatory effects during exercise, in patients with COPD. We therefore evaluated whether PAV modulates the kinetic and 'steady-state' haemodynamic responses to exercise in patients with moderate-to-severe COPD. ⋯ PAV slowed the SV and CO kinetics at the onset of high-intensity exercise in selected patients with moderate-to-severe COPD. However, these adverse effects of PAV disappeared during the stable phase of exercise, and were not related to the ergogenic potential of PAV in this patient population.
-
Pulmonary rehabilitation plays an essential role in the management of symptomatic patients with COPD. The benefits of rehabilitation include a decrease in dyspnoea and fatigue, and improvements in exercise tolerance and health-related quality of life. Importantly, rehabilitation reduces hospitalization for acute exacerbations and is cost-effective. ⋯ Different approaches for delivering the education component of a PRP are outlined and recommendations are made regarding topics for group and individual sessions. The problems commonly encountered in pulmonary rehabilitation, together with recommendations to avoid these problems and strategies to assist in their resolution, are discussed. The review concludes with recommendations for evaluating a PRP.
-
During wakefulness, the electromyography (EMG) activities of upper airway dilator muscles are higher in OSA syndrome (OSAS) patients than those in normal subjects. This is believed to be related to central compensatory mechanisms. This study aimed to assess the central motor conductivity of genioglossus (GG) during wakefulness and to evaluate the compensatory site in OSAS patients. ⋯ OSAS patients have an increased central motor conductivity of GG than normal subjects. Furthermore, this increased central motor conductivity of GG is related to the severity of OSAS.
-
The six-minute walk test (6MWT) is widely used as an outcome measure in pulmonary rehabilitation programs (PRP). A learning effect for the test has been reported in COPD; however, limited data exist in patients with other respiratory diagnoses. The objectives of this study were to: (i) report the magnitude of change in 6MWD with test repetition in patients referred to an outpatient PRP, and (ii) compare the magnitude of change in 6MWD with test repetition in patients with COPD, interstitial lung disease (ILD), bronchiectasis and asthma. ⋯ Respiratory diagnosis influences the magnitude of the learning effect for the 6MWT. The findings support the recommendation of a practice 6MWT at baseline assessment in order to provide an accurate measure of the effects of rehabilitation on 6MWD.