Can non-invasive ventilation modulate cerebral, respiratory, and peripheral muscle oxygenation during high-intensity exercise in patients with COPD-HF?
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Universidade Federal de São Carlos
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Aim: To evaluate the effect of non-invasive positive pressure ventilation (NIPPV) on (1) metabolic, ventilatory, and hemodynamic responses; and (2) cerebral (Cox), respiratory, and peripheral oxygenation when compared with SHAM ventilation during the high-intensity exercise in patients with coexisting chronic obstructive pulmonary disease (COPD) and heart failure (HF). Methods and Results: On separate days, patients performed incremental cardiopulmonary exercise testing and two constant-work rate tests receiving NIPPV or controlled ventilation (SHAM) (the bilevel mode—Astral 150) in random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin (OxyHb+Mb) and deoxyhemoglobin (DeoxyHb+Mb) were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, The Netherlands). NIPPV associated with high-intensity exercise caused a significant increase in exercise tolerance, peak oxygen consumption (V⋅O2 in mlO2·kg−1·min−1), minute ventilation peak (V⋅E in ml/min), peak peripheral oxygen saturation (SpO2, %), and lactate/tlim (mmol/s) when compared with SHAM ventilation. In cerebral, respiratory, and peripheral muscles, NIPPV resulted in a lower drop in OxyHb+Mb (p < 0.05) and an improved deoxygenation response DeoxyHb+Mb (p < 0.05) from the half of the test (60% of Tlim) when compared with SHAM ventilation. Conclusion: Non-invasive positive pressure ventilation during constant work-rate exercise led to providing the respiratory muscle unloading with greater oxygen supply to the peripheral muscles, reducing muscle fatigue, and sustaining longer exercise time in patients with COPD-HF.
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GOULART, Cássia da Luz; CARUSO, Flávia Rossi; ARAÚJO, Adriana Sanches Garcia de; MOURA, Silvia Cristina Garcia de; CATAI, Aparecida Maria; AGOSTONI, Piergiuseppe; MENDES, Renata Gonçalves; ARENA, Ross; SILVA, Audrey Borghi. Can non-invasive ventilation modulate cerebral, respiratory, and peripheral muscle oxygenation during high-intensity exercise in patients with COPD-HF?. Repositório Institucional da UFSCar, 2022. Dataset. Disponível em: https://repositorio.ufscar.br/handle/20.500.14289/15576.
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