The Effects of Helium-Hyperoxia on 6-min Walking Distance in COPD

Marciniuk, Darcy; Butcher, Scotty; Reid, John; MacDonald, Giles F.; Eves, Neil D.; Clemens, Ron; Jones, Richard L.

doi:10.1378/chest.06-2514

Cited by 22 publications

(49 citation statements)

References 25 publications

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“…Walking may be a mode of exercise testing that better relates to functional activities in patients with COPD [31]; however, cycling is still used prominently as a testing and training modality. Heliox has also been shown to increase exercise tolerance during walking endurance tests [31,32]; however, walking exercise results in lower levels of leg muscle fatigue than cycling exercise [33]. It is likely that the effects of heliox on walking performance would not result in significant levels of leg muscle fatigue.…”

Section: Limitationsmentioning

confidence: 99%

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Butcher

Lagerquist²,

Marciniuk³

et al. 2009

European Respiratory Journal

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Dynamic hyperinflation and leg muscle fatigue are independently associated with exercise limitation in patients with chronic obstructive pulmonary disease (COPD). The aims of the present study were to examine 1) the relationship between these limitations and 2) the effect of delaying ventilatory limitation on exercise tolerance and leg muscle fatigue.In total, 11 patients with COPD (with a forced expiratory volume in one second of 52% predicted) completed two cycling bouts breathing either room air or heliox, and one bout breathing heliox but stopping at room air isotime. End-expiratory lung volume (EELV), leg muscle fatigue and exercise time were measured.On room air, end-exercise EELV was negatively correlated with leg fatigue. Heliox increased exercise time (from 346 to 530 s) and leg fatigue (by 15%). At isotime, there was no change in leg fatigue, despite a reduction in EELV compared with end-exercise, in both room air and heliox. The change in exercise time with heliox was best correlated with room air leg fatigue and endinspiratory lung volume.Patients with chronic obstructive pulmonary disease who had greater levels of dynamic hyperinflation on room air had less muscle fatigue. These patients were more likely to increase exercise tolerance with heliox, which resulted in greater leg muscle fatigue.

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Section: Limitationsmentioning

confidence: 99%

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Butcher

Lagerquist²,

Marciniuk³

et al. 2009

European Respiratory Journal

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“…These strategies range from novel approaches such as noninvasive positive pressure ventilation [27] and neuromuscular electrical stimulation [31] to ''older'' adjuncts such as oxygen supplementation (HOx) [6,7] and low-density gas breathing (helium) [9][10][11][12][13]. In this context, the present results are encouraging in relation to the benefits of adding helium to HOx in hypoxaemic patients, as maximal and submaximal exercise capacity further increased in two-thirds of them.…”

Section: Discussionmentioning

confidence: 79%

“…This is justified by the overwhelming evidence that HOx decreases ventilatory demands, the rate of dynamic hyperinflation and breathlessness [6,7] while enhancing cardiocirculatory adjustments to exertion [8]. More recently, adding helium to HOx (HeHOx) [9][10][11][12][13] has opened a new perspective to further improving exercise tolerance in these patients. Of note, HeHOx also delayed dynamic hyperinflation and lowered ventilatory drive, at least in nonhypoxemic patients [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…More recently, adding helium to HOx (HeHOx) [9][10][11][12][13] has opened a new perspective to further improving exercise tolerance in these patients. Of note, HeHOx also delayed dynamic hyperinflation and lowered ventilatory drive, at least in nonhypoxemic patients [9][10][11][12][13]. Moreover, helium in normoxia significantly accelerated oxygen uptake (V9O 2 ) kinetics [14,15] and reduced muscle fatigue [16], an effect that might be related to its deflating effects, leading to improved central haemodynamics and convective oxygen delivery [14,17].…”

Section: Introductionmentioning

confidence: 99%

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Exercise tolerance with helium-hyperoxiaversushyperoxia in hypoxaemic patients with COPD

et al. 2012

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The purpose of this study was to investigate whether helium-hyperoxia (HeHOx) would allow greater tolerance to maximal and submaximal exercise compared to hyperoxia (HOx) on isolation in hypoxaemic chronic obstructive pulmonary disease (COPD) patients under long-term oxygen therapy.In a double-blind study, 24 males in the Global Initiative for Chronic Obstructive Lung Disease functional class IV (forced expiratory volume in 1 s 35.2¡10.1% predicted and arterial oxygen tension 56.2¡7.5 mmHg) were submitted to incremental and constant load cycling at 70-80% peak work rate while breathing HOx (60% nitrogen and 40% oxygen) or HeHOx (60% helium and 40% oxygen).HeHOx improved resting airflow obstruction and lung hyperinflation in all but two patients (p,0.05). Peak work rate and time to exercise intolerance were higher with HeHOx than HOx in 17 (70.8%) out of 24 patients and 14 (66.6%) out of 21 patients, respectively (p,0.05). End-expiratory lung volumes were lower with HeHOx, despite a higher ventilatory response (p,0.05). HeHOx speeded on-exercise oxygen uptake kinetics by ,30%, especially in more disabled and hyperinflated patients. Fat-free mass was the only independent predictor of higher peak work rate with HeHOx (r 2 50.66, p,0.001); in contrast, none of the resting characteristics or exercise responses were related to improvements in time to exercise intolerance (p.0.05).Helium is a valuable ergogenic aid when added to HOx for most long-term oxygen therapy-dependent patients with advanced COPD. @ERSpublications Helium is a valuable ergogenic aid when added to hyperoxia for most advanced COPD patients on long-term oxygen therapy

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“…While three studies explicitly documented the methods used to estimate sample size [30][31][32], the majority of studies did not report sample estimates. In addition, poorly matched control subjects, failure to meet sample size estimates and failure to address confounding issues contributed to uncertainty in assessing levels of bias for individual studies.…”

Section: Ventilation and The Work Of Breathingmentioning

confidence: 99%

Heliox, dyspnoea and exercise in COPD

Hunt¹,

Williams²,

Frith³

et al. 2010

European Respiratory Review

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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.

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The Effects of Helium-Hyperoxia on 6-min Walking Distance in COPD

Cited by 22 publications

References 25 publications

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Relationship between ventilatory constraint and muscle fatigue during exercise in COPD

Exercise tolerance with helium-hyperoxiaversushyperoxia in hypoxaemic patients with COPD

Heliox, dyspnoea and exercise in COPD

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