Non invasive ventilation as an additional tool for exercise training

Abstract

Recently, there has been increasing interest in the use of non invasive ventilation (NIV) to increase exercise capacity. In individuals with COPD, NIV during exercise reduces dyspnoea and increases exercise tolerance.Different modalities of mechanical ventilation have been used non-invasively as a tool to increase exercise tolerance in COPD, heart failure and lung and thoracic restrictive diseases. Inspiratory support provides symptomatic benefit by unloading the ventilatory muscles, whereas Continuous Positive Airway Pressure (CPAP) counterbalances the intrinsic positive end-expiratory pressure in COPD patients.Severe stable COPD patients undergoing home nocturnal NIV and daytime exercise training showed some benefits. Furthermore, it has been reported that in chronic hypercapnic COPD under long-term ventilatory support, NIV can also be administered during walking.Despite these results, the role of NIV as a routine component of pulmonary rehabilitation is still to be defined.

Intermittent Use of Portable NIV Increases Exercise Tolerance in COPD: A Randomised, Cross-Over Trial

“…NIV has previously been used during exercise training in patients with severe COPD to lessen breathlessness and increase exercise capacity [11,26]. A Cochrane analysis of studies using NIV during exercise training provides conflicting and moderate quality evidence of beneficial effects on exercise capacity and the role of this intervention remains unclear [27,28,29,30,31].…”

“…Heliox supplementation is beneficial but impractical and expensive; therefore, it has primarily been used for research purposes [10]. Standard NIV is infrequently used due to the application of bulky equipment and the need for close supervision during exercise training [11].…”

Hypercapnic COPD patients and NIV at home: is there any benefit? Using the CAT and BODE index in an effort to prove benefits of NIV in these patients

“…The insignificant improvement over time could be attributed to the fact that our patients did not follow a rehabilitation program in order to maintain their improvement. 44 …”

Increased exercise tolerance using daytime mouthpiece ventilation for patients with diaphragm paralysis

“…The use of night-time NIV in patients with chronic respiratory failure has been proven to be successful [ 5 , 6 ]. In addition, NIV during exercise is previously found out to be successful in chronic obstructive pulmonary disease patients and, with a lower level of evidence, in patients with restrictive lung disease [ 7 ]. An appropriate interface is crucial for successful NIV, both during the night and during exercise [ 8 ].…”