Non-invasive ventilatory support accelerates the oxygen uptake and heart rate kinetics and improves muscle oxygenation dynamics in COPD-HF patients

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Simoes, Rodrigo Polaquini ; Goulart, Cassia da Luz ; Caruso, Flavia Rossi ; Araujo, Adriana S. Garcia de ; de Moura, Silvia Cristina Garcia ; Catai, Aparecida Maria ; dos Santos, Polliana Batista ; Camargo, Patricia de Faria ; Marinho, Renan Shida ; Mendes, Renata Goncalves ; Borghi-Silva, Audrey

• Tipo de documento: Artigo Científico
• Fonte: AMERICAN JOURNAL OF THE MEDICAL SCIENCES; v. 366, n. 2, p. 11-pg., 2023-08-01.

Resumo

Background: The aim of this study was to explore the effects of non-invasive positive pressure ventilation (NIPPV) associated with high-intensity exercise on heart rate (HR) and oxygen uptake (V?O-2) recovery kinetics in in patients with coexistence of chronic obstructive pulmonary disease (COPD) and heart failure (HF). Methods: This is a randomized, double blinded, sham-controlled study involving 14 HF-COPD patients, who underwent a lung function test and Doppler echocardiography. On two different days, patients performed incremental cardiopulmonary exercise testing (CPET) and two constant-work rate tests (80% of CPET peak) receiving Sham or NIPPV (bilevel mode -Astral 150) in a random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin and deoxyhemoglobin were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, Netherland).Results: The kinetic variables of both V?O(2 )and HR during the high-intensity constant workload protocol were significantly faster in the NIPPV protocol compared to Sham ventilation (P < 0.05). Also, there was a marked improvement in oxygenation and lower deoxygenation of both peripheral and respiratory musculature in TLim during NIPPV when contrasted with Sham ventilation.Conclusions: NIPPV applied during high-intensity dynamic exercise can effectively improve exercise tolerance, accelerate HR and V?O2 kinetics, improve respiratory and peripheral muscle oxygenation in COPD-HF patients. These beneficial results from the effects of NIPPV may provide evidence and a basis for high-intensity physical training for these patients in cardiopulmonary rehabilitation programs. (AU)

• Processo FAPESP: 18/03233-0 - Estudo da interação cardiorrespiratória e da oferta de oxigênio periférica e cerebral como moduladores da capacidade de exercício durante a aplicação do binível na coexistência da DPOC-ICC
• Beneficiário: Cássia da Luz Goulart
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 20/13465-5 - Identificação de variáveis prognósticas do teste de exercício cardiopulmonar para estratificar gravidade da insuficiência cardíaca
• Beneficiário: Cássia da Luz Goulart
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado Direto