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Clinical Trial
. 2011 Dec 16:11:58.
doi: 10.1186/1471-2466-11-58.

Non-invasive ventilation (NIV) as an aid to rehabilitation in acute respiratory disease

Fran Dyer  1 , Lizzie Flude, Farid Bazari, Caroline Jolley, Catherine Englebretsen, Dilys Lai, Michael I Polkey, Nicholas S Hopkinson
Affiliations
Clinical Trial

Non-invasive ventilation (NIV) as an aid to rehabilitation in acute respiratory disease

Fran Dyer et al. BMC Pulm Med. .

Abstract

Background: Non-invasive ventilation (NIV) can increase exercise tolerance, reduce exercise induced desaturation and improve the outcome of pulmonary rehabilitation in patients with chronic respiratory disease. It is not known whether it can be applied to increase exercise capacity in patients admitted with non-hypercapnic acute exacerbations of COPD (AECOPD). We investigated the acceptability and feasibility of using NIV for this purpose.

Methods: On a single occasion, patients admitted with an acute exacerbation of chronic respiratory disease who were unable to cycle for five minutes at 20 watts attempted to cycle using NIV and their endurance time (T(lim)) was recorded. To determine feasibility of this approach in clinical practice patients admitted with AECOPD were screened for participation in a trial of regular NIV assisted rehabilitation during their hospital admission.

Results: In 12 patients tested on a single occasion NIV increased T(lim) from 184(65) seconds to 331(229) seconds (p = 0.04) and patients desaturated less (median difference = 3.5%, p = 0.029). In the second study, 60 patients were admitted to hospital during a three month period of whom only 18(30)% were eligible to participate and of these patients, only four (7%) consented to participate.

Conclusion: NIV improves exercise tolerance in patients with acute exacerbations of chronic respiratory disease but the applicability of this approach in routine clinical practice may be limited.

Trial registration: http://www.controlled-trials.com/ISRCTN35692743.

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Figures

Figure 1
Figure 1
Cycle endurance time at 20w increased with NIV support (p 0.04). n = 12 Horizontal bars represent mean values.
Figure 2
Figure 2
Work done during cycle ergometry increased with NIV support (p = 0.016). Horizontal bar represents mean values.
See this image and copyright information in PMC

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