Cited by 132Respiratory Support and MechanismsCardiovascular and exercise physiologyChronic Obstructive Pulmonary Disease (COPD) Research

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Pressure Support Reduces Inspiratory Effort and Dyspnea during Exercise in Chronic Airflow Obstruction

Maltais, François, Reissmann, Hajo, Gottfried, Stewart B.·1995·American Journal of Respiratory and Critical Care Medicine

DOI 10.1164/ajrccm/151.4.1027

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Abstract

Exercise training has been of limited success in patients with severe chronic airflow obstruction (CAO), in part because of the reduced ventilatory capacity and excessive dyspnea experienced. Pressure support (PS) is a new form of mechanical ventilation which can effectively assist ventilation when applied noninvasively to patients in acute respiratory failure. It was hypothesized that PS might also be used to improve exercise performance, and ultimately physical conditioning, in ambulatory patients with CAO undergoing exercise training. To begin to address this concept, the objectives of the present study were (1) to examine the feasibility of providing PS to exercising patients with CAO and (2) to determine its effects on breathing pattern, inspiratory effort, and dyspnea. Flow and volume, mouth, esophageal, and gastric pressure were measured in seven patients with severe CAO (mean FEV1 = 0.75 +/- SEM 0.09 L) performing constant workload bicycle exercise (33 +/- 6 watts) during control conditions and with the application of PS (approximately 10 cm H2O). PS increased minute ventilation as a result of changes in both tidal volume and respiratory rate. This occurred despite marked reductions in inspiratory effort, as indicated by the pressure-time integrals of esophageal (68 +/- 5% control, p < 0.0005) and transdiaphragmatic pressure (52 +/- 8% control, p < 0.0005). Using a 5-point bidirectional scale to assess changes in dyspnea, breathlessness improved significantly with the addition of PS (2.3 +/- 0.6, p < 0.05) and worsened to a similar degree when it was removed (2.1 +/- 0.5, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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Effects of Pressure Support Ventilation May Be Lost at High Exercise Intensities in People with COPD
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Authors: Maltais, F., Reissmann, H., & Gottfried, S. B.
Affiliations: Montreal General Hospital (CA)
ORCID: Maltais, François
Venue: American Journal of Respiratory and Critical Care Medicine
Publisher: Oxford University Press (OUP)
Published: 1995-04-01
Volume: 151
Issue: 4
Pages: 1027-1033
ISSN: 1073-449X (ISSN-L)
1535-4970
DOI: 10.1164/ajrccm/151.4.1027
OpenAlex: W2059358834
Cited by: 132
References: 0
Citations by year: 2024: 2 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 9 · 2014: 8 · 2013: 6 · 2012: 5
FWCI: 3.95
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations: American Journal of Respiratory and Critical Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords: pressure support ventilation, chronic airflow obstruction, exercise training, inspiratory effort, dyspnea, esophageal pressure, transdiaphragmatic pressure, minute ventilation, breathing pattern, exercise performance, non-invasive ventilation
MeSH terms: Adult, Aged, Dyspnea, Female, Humans, Lung Diseases, Obstructive, Male, Middle Aged, Respiration, Artificial, Respiratory Muscles, Exercise, Respiratory Mechanics

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Pressure Support Reduces Inspiratory Effort and Dyspnea during Exercise in Chronic Airflow Obstruction

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