Heliox, dyspnoea and exercise in COPD

Abstract

One of the most important determinants of physical and mental well-being of people with chronic obstructive pulmonary disease (COPD) is participation in physical activity. The ability to alter the sensation of dyspnoea during exercise may improve both exercise duration and intensity. Despite the low density, inert nature, strong safety profile and multiple applications of helium gas, the potential benefit of helium-oxygen gas mixtures as an adjunct therapy to modify disease symptoms and exercise capabilities in obstructive lung diseases has only recently been explored. This is a systematic review of the available peer-reviewed evidence exploring whether symptom modification (perceived levels of dyspnoea) and exercise performance in COPD (either intensity or duration of work) are modified by inhalation of Heliox. Eight experimental studies met inclusion for this review. A variety of methodologies and outcome variables were used negating metaanalysis and hampering direct comparison between interventions. Overall, there was high level of evidence with a low risk of bias supporting Heliox's effectiveness in improving the intensity and endurance of exercise when compared to room air for people with COPD. Little conclusive evidence was found to determine whether Heliox altered the sensation of dyspnoea during exercise.

Lighter than air: heliox breathing improves exercise tolerance in COPD

“…Importantly, as for the results of their review analysis, HUNT et al [6] concluded that: ''Overall, the eight studies included in this review presented a case for high level, low risk of bias evidence to support the effectiveness of heliox in improving the intensity and endurance of exercise when compared to room air for people with COPD.''. In contrast, the review by HUNT et al [6] failed to demonstrate a significant reduction in exertional dyspnoea induced by heliox breathing. It should be noted, however, that dyspnoea was not the primary outcome in these studies and that differences in the studied patient population and exercise protocols utilised (i.e.…”

“…In their study, HUNT et al [6] clearly illustrate the rationale beyond the use of heliox during exercise in COPD and adequately summarise the relevant results of these research articles. Importantly, as for the results of their review analysis, HUNT et al [6] concluded that: ''Overall, the eight studies included in this review presented a case for high level, low risk of bias evidence to support the effectiveness of heliox in improving the intensity and endurance of exercise when compared to room air for people with COPD.''. In contrast, the review by HUNT et al [6] failed to demonstrate a significant reduction in exertional dyspnoea induced by heliox breathing.…”

“…The effects of breathing lowdensity gas mixtures (i.e heliox or helium+oxygen) during exercise have only been tested recently: the results of eight important studies published in this field have been reviewed by HUNT et al [6] in the current issue of the European Respiratory Review. In their study, HUNT et al [6] clearly illustrate the rationale beyond the use of heliox during exercise in COPD and adequately summarise the relevant results of these research articles.…”

“…The effects of breathing lowdensity gas mixtures (i.e heliox or helium+oxygen) during exercise have only been tested recently: the results of eight important studies published in this field have been reviewed by HUNT et al [6] in the current issue of the European Respiratory Review. In their study, HUNT et al [6] clearly illustrate the rationale beyond the use of heliox during exercise in COPD and adequately summarise the relevant results of these research articles. Importantly, as for the results of their review analysis, HUNT et al [6] concluded that: ''Overall, the eight studies included in this review presented a case for high level, low risk of bias evidence to support the effectiveness of heliox in improving the intensity and endurance of exercise when compared to room air for people with COPD.''.…”

Update on the European Respiratory Review

“…Alongside this presentation of the advances made in COPD therapies, the difficulty in treating patients and designing trials for such a heterogeneous disease was discussed, and the need for not only the publication of treatment guidelines, but a more universal adherence to them, was emphasised. Also featured in the March 2010 issue was a systematic review of the effects of Heliox therapy on exercise performance and dyspnoea perception in COPD patients [15], as well as a discussion of the mechanisms by which pulmonary rehabilitation can benefit those with COPD, and how this benefit may extend to a wider population in the future [16]. Important advances in the understanding of the diffuse parenchymal lung diseases were communicated by HARARI and CAMINATI [17] in June 2010, with particular interest in the progress made in the field of idiopathic pulmonary fibrosis.…”