Efficacy of Nasal High-Flow Oxygen Therapy in Chronic Obstructive Pulmonary Disease Patients in Long-Term Oxygen and Nocturnal Non-Invasive Ventilation during Exercise Training
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Participants
- A diagnosis of moderate to severe chronic obstructive pulmonary disease (COPD) according to Vogelmeier et al. [17].
- Age ranging from 18 to 80 years.
- Nocturnal non-invasive-ventilation (NIV) prescription according to the ATS/ERS guidelines, with long-term oxygen therapy [18].
- Clinical stability (no exacerbation and no change in, or addition of, respiratory drugs in the last month) [19].
- No COVID-19-related infections associated
- Orthopedic or neurological pathologies that limit the patient’s physical performance.
- Cognitive impairment (Mini-Mental State Examination < 24) [20].
- Advanced heart disease (NYHA class > 2) classes of heart failure (American Heart Association) [21].
- NIV compliance that is inferior to 5 h per night [22].
2.3. Interventions
2.4. Run-In Phase
2.5. Exercise Training Program
- Warm-up: 5 min at 0 watts.
- Training: 30 min of resistance training at 60–80% of the maximal workload. Patients had to maintain a cycling rate ranging between 40 and 50 rpm.
- Cooldown: 5 min at 0 watts.
2.6. Measurements
- 4.
- T0: baseline.
- 5.
- T1: at the end of the first 20 sessions of the rehabilitation cycle.
- 6.
- T2: at the end of the second 20 sessions of the rehabilitation cycle.
- 7.
- T3: at the end of the third 20 sessions of the rehabilitation cycle.
2.7. Outcome Measures
2.8. Statistical Analysis
3. Results
3.1. Primary Outcome
3.2. Secondary Outcomes
4. Discussion
4.1. Strengths of the Study
4.2. Limitations of the Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Time | Blood Gas Analysis | Spirometry | mMRC | 6MWT | CAT | SGRQ | Borg Dyspnea |
---|---|---|---|---|---|---|---|
T0, baseline | X | X | X | X | X | X | X |
T1 | X | X | X | X | X | ||
T2 | X | X | X | X | X | ||
T3 | X | X | X | X | X | X | X |
Characteristics | Experimental Group | Control Group | p Value |
---|---|---|---|
N (%) | 15 (48.3) | 16 (51.7) | |
Age | 75.7 (±7.50) | 75.4 (±9.36) | |
Female | 60% (±0.50) | 25% (±0.44) | <0.001 |
Active Smokers (n) | 13% (2) | 7% (1) | <0.001 |
p/y | 46.1 (±33.9) | 53.9 (±21.6) | |
pH | 7.41 (±0.016) | 7.40 (±0.03) | 0.579 |
PaCO2 | 53 (±5.95) | 50.75 (±3.43) | 0.237 |
PaO2 | 75.5 (±9.11) | 67.9 (±12.5) | 0.064 |
HCO3- | 30.2 (±4.47) | 27.7 (±4.60) | 0.077 |
BE | 5.96 (±5.14) | 3.73 (±4.56) | 0.122 |
FVC % | 58.3 (±16) | 58.3 (±19.8) | 0.991 |
FEV1% | 33.6 (±9.90) | 44.19 (±13.6) | 0.985 |
FEV1/FVC | 44.5 (±10.4) | 47.1 (±10.2) | 0.774 |
DLCO | 40 (±10.2) | 44.4 (±16.9) | 0.797 |
6MWD | 222 (±68.2) | 251 (±83.3) | 0.902 |
Borg D PRE | 1.93 (±2.1) | 1.31 (±1.35) | 0.340 |
Borg D POST | 6.11 (±2.8) | 5.8 (±2.73) | 0.321 |
Borg F PRE | 0.50 (±1.11) | 1.03 (±1.11) | 0.951 |
Borg F POST | 3.34 (±3.55) | 4.06 (±2.26) | 0.834 |
CAT | 19.93 (±5.66) | 17.50 (±6.95) | 0.095 |
mMRC | 3.20 (±1.01) | 3.19 (±0.91) | 0.432 |
SGRQ | 89.73 (±5.84) | 90.44 (±6.45) | 0.624 |
Borg | Experimental | Control | Mean Difference | p-Value | ||
---|---|---|---|---|---|---|
T0 | ||||||
D1 | 1.93 (±2.1) | 1.31 (±1.35) | T1 | |||
1.92 (2.10) | 1.31 (1.35) | 0.01 | 1.00 | |||
T2 | ||||||
2 (2.12) | 1.12 (1.0) | 1.50 | 0.047 | |||
T3 | ||||||
1.07 (±1.04) | 1.00 (±0.63) | 1.00 | 0.01 | |||
D2 | 6.11 (±2.8) | 5.8 (±2.73) | T1 | |||
4.80 (1.95) | 4.75 (1.69) | 2.00 | <0.001 | |||
T2 | ||||||
5.11 (1.36) | 4.44 (1.26) | 2.01 | <0.001 | |||
T3 | ||||||
4.0 (±1.6) | 3.68 (±1.3) | 2.50 | <0.001 | |||
F1 | 0.50 (±1.11) | 1.03 (±1.11) | T1 | |||
0.5 (1.12) | 1.03 (1.12) | 0.001 | 1.00 | |||
T2 | ||||||
0.61 (1.32) | 1.03 (1.12) | 0.01 | 1.00 | |||
T3 | ||||||
0.31 (±0.63) | 0.50 (±0.63) | 1.00 | 0.003 | |||
F2 | 3.34 (±3.55) | 4.06 (±2.26) | T1 | |||
2.92 (2.6) | 3.44 (1.63) | 1.00 | 0.005 | |||
T2 | ||||||
3.11 (2.98) | 3.44 (1.63) | 1.00 | 0.005 | |||
T3 | ||||||
2.1 (±2.1) | 2.63 (±1.3) | 2.00 | <0.001 |
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Volpi, V.; Volpato, E.; Compalati, E.; Lebret, M.; Russo, G.; Sciurello, S.; Pappacoda, G.; Nicolini, A.; Banfi, P. Efficacy of Nasal High-Flow Oxygen Therapy in Chronic Obstructive Pulmonary Disease Patients in Long-Term Oxygen and Nocturnal Non-Invasive Ventilation during Exercise Training. Healthcare 2022, 10, 2001. https://doi.org/10.3390/healthcare10102001
Volpi V, Volpato E, Compalati E, Lebret M, Russo G, Sciurello S, Pappacoda G, Nicolini A, Banfi P. Efficacy of Nasal High-Flow Oxygen Therapy in Chronic Obstructive Pulmonary Disease Patients in Long-Term Oxygen and Nocturnal Non-Invasive Ventilation during Exercise Training. Healthcare. 2022; 10(10):2001. https://doi.org/10.3390/healthcare10102001
Chicago/Turabian StyleVolpi, Valeria, Eleonora Volpato, Elena Compalati, Marius Lebret, Giuseppe Russo, Salvatore Sciurello, Gabriele Pappacoda, Antonello Nicolini, and Paolo Banfi. 2022. "Efficacy of Nasal High-Flow Oxygen Therapy in Chronic Obstructive Pulmonary Disease Patients in Long-Term Oxygen and Nocturnal Non-Invasive Ventilation during Exercise Training" Healthcare 10, no. 10: 2001. https://doi.org/10.3390/healthcare10102001