Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation
Summary Background It is currently unknown whether potential haemodynamic improvements induced by non‐invasive ventilation (NIV) would positively impact upon cerebral oxygenation (COx) in patients with moderate‐to‐severe chronic obstructive pulmonary disease (COPD). Objective To investigate the effe...
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| Veröffentlicht in: | Clinical physiology and functional imaging 2013-07, Vol.33 (4), p.274-281 |
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| creator | Rodrigues, Miguel K. Oliveira, Mayron F. Soares, Aline Treptow, Erika Neder, J Alberto |
| description | Summary
Background
It is currently unknown whether potential haemodynamic improvements induced by non‐invasive ventilation (NIV) would positively impact upon cerebral oxygenation (COx) in patients with moderate‐to‐severe chronic obstructive pulmonary disease (COPD).
Objective
To investigate the effects of NIV on exercise COx in COPD patients presenting with exercise‐related O2 desaturation.
Methods
On a double‐blind trial, 13 males (FEV1 = 48·8 ± 15·1% predicted) were randomly assigned to NIV (16 cmH2O IPS and 5 cmH2O PEEP) plus HOx (FiO2 = 0·4) or sham NIV (7 cmH2O IPS and 5 cmH2O PEEP to overcome breathing circuit resistance) plus HOx during ramp‐incremental exercise performed on different days. Near‐infrared spectroscopy and impedance cardiography assessed changes (Δ) in COx and cardiac output (QT), respectively.
Results
There were no significant between‐intervention differences in peak work rate, ventilation and reported symptoms (P>0·05). Peripheral oxyhaemoglobin saturation remained above 98% throughout the tests. NIV + HOx was associated with larger increases in Δ COx, Δ QT and Δ stroke volume at maximal and submaximal exercise (P |
| doi_str_mv | 10.1111/cpf.12024 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1372625616</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1372625616</sourcerecordid><originalsourceid>FETCH-LOGICAL-i3504-458d69f930e40c3d6fd208333a358f595b61322f64b2aaa84be79efbbd82aad73</originalsourceid><addsrcrecordid>eNqNkc1y0zAUhTUMDC2BBS_AaIYNG7f6V7wshhZmCukCptlpZOuKqji2kew0eQMeGyUpWbBCG90jfefekQ5Cryk5o3mdN4M_o4ww8QSdUqFlQUq9fHqsFT1BL1K6J4RqLvRzdMK4Kpmi6hT9vnAujGENGLyHZky497jruyJ0a5t252voxtDaMfQdHnt8tx0g9ptgcdYNRKijbXG_2f6A7gCFDleLmw94yDJ7E34I4x2GDcQmJCgi5Gbg8IJhB8mOU9zbXqJn3rYJXj3uM_T98uO36lNxvbj6XF1cF4FLIgoh506VvuQEBGm4U94xMuecWy7nXpayVpQz5pWombV2LmrQJfi6dvOsneYz9O7Qd4j9rwnSaFYhNdC2toN-SoZyzRST-XP-A5VCl0Tm8TP09h_0vp9ilx-yozjXgnOSqTeP1FSvwJkhhpWNW_M3jgycH4CH0ML2eE-J2eVscs5mn7Opbi73RXYUB0dII2yODht_GqW5lub265Uh1Xu1XH65NRX_A76VqkI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1353374330</pqid></control><display><type>article</type><title>Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rodrigues, Miguel K. ; Oliveira, Mayron F. ; Soares, Aline ; Treptow, Erika ; Neder, J Alberto</creator><creatorcontrib>Rodrigues, Miguel K. ; Oliveira, Mayron F. ; Soares, Aline ; Treptow, Erika ; Neder, J Alberto</creatorcontrib><description>Summary
Background
It is currently unknown whether potential haemodynamic improvements induced by non‐invasive ventilation (NIV) would positively impact upon cerebral oxygenation (COx) in patients with moderate‐to‐severe chronic obstructive pulmonary disease (COPD).
Objective
To investigate the effects of NIV on exercise COx in COPD patients presenting with exercise‐related O2 desaturation.
Methods
On a double‐blind trial, 13 males (FEV1 = 48·8 ± 15·1% predicted) were randomly assigned to NIV (16 cmH2O IPS and 5 cmH2O PEEP) plus HOx (FiO2 = 0·4) or sham NIV (7 cmH2O IPS and 5 cmH2O PEEP to overcome breathing circuit resistance) plus HOx during ramp‐incremental exercise performed on different days. Near‐infrared spectroscopy and impedance cardiography assessed changes (Δ) in COx and cardiac output (QT), respectively.
Results
There were no significant between‐intervention differences in peak work rate, ventilation and reported symptoms (P>0·05). Peripheral oxyhaemoglobin saturation remained above 98% throughout the tests. NIV + HOx was associated with larger increases in Δ COx, Δ QT and Δ stroke volume at maximal and submaximal exercise (P<0·05). Increases in the area under the curve (to an iso‐work rate) of Δ COx under NIV + HOx were significantly (P<0·01) correlated with improvements in Δ QT (r = 0·82) and Δ stroke volume (r = 0·87). There was, however, no significant correlation between enhancement in these physiological responses with changes in peak work rate with NIV + HOx (P>0·05).
Conclusions
NIV added benefit to HOx in improving central haemodynamics and COx in O2 ‘desaturators’ with COPD. The clinical relevance of such beneficial effects on exercise tolerance, however, remains to be demonstrated.</description><identifier>ISSN: 1475-0961</identifier><identifier>EISSN: 1475-097X</identifier><identifier>DOI: 10.1111/cpf.12024</identifier><identifier>PMID: 23692616</identifier><identifier>CODEN: CPFICA</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Brazil ; Cardiac Output ; Cardiography, Impedance ; cerebral oxygenation ; Cerebrovascular Circulation ; chronic obstructive pulmonary disease ; Double-Blind Method ; Exercise ; Exercise Tolerance ; Forced Expiratory Volume ; Humans ; Hypoxia - blood ; Hypoxia - physiopathology ; Lung - physiopathology ; lung physiology ; Male ; Middle Aged ; near-infrared spectroscopy ; non-invasive ventilation ; Noninvasive Ventilation - methods ; Oxygen - blood ; Oxygen Consumption ; Positive-Pressure Respiration ; Pulmonary Disease, Chronic Obstructive - blood ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Disease, Chronic Obstructive - therapy ; Spectroscopy, Near-Infrared ; Time Factors ; Treatment Outcome</subject><ispartof>Clinical physiology and functional imaging, 2013-07, Vol.33 (4), p.274-281</ispartof><rights>2013 The Authors Clinical Physiology and Functional Imaging © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine</rights><rights>2013 The Authors Clinical Physiology and Functional Imaging © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine.</rights><rights>Copyright © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcpf.12024$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcpf.12024$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23692616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodrigues, Miguel K.</creatorcontrib><creatorcontrib>Oliveira, Mayron F.</creatorcontrib><creatorcontrib>Soares, Aline</creatorcontrib><creatorcontrib>Treptow, Erika</creatorcontrib><creatorcontrib>Neder, J Alberto</creatorcontrib><title>Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation</title><title>Clinical physiology and functional imaging</title><addtitle>Clin Physiol Funct Imaging</addtitle><description>Summary
Background
It is currently unknown whether potential haemodynamic improvements induced by non‐invasive ventilation (NIV) would positively impact upon cerebral oxygenation (COx) in patients with moderate‐to‐severe chronic obstructive pulmonary disease (COPD).
Objective
To investigate the effects of NIV on exercise COx in COPD patients presenting with exercise‐related O2 desaturation.
Methods
On a double‐blind trial, 13 males (FEV1 = 48·8 ± 15·1% predicted) were randomly assigned to NIV (16 cmH2O IPS and 5 cmH2O PEEP) plus HOx (FiO2 = 0·4) or sham NIV (7 cmH2O IPS and 5 cmH2O PEEP to overcome breathing circuit resistance) plus HOx during ramp‐incremental exercise performed on different days. Near‐infrared spectroscopy and impedance cardiography assessed changes (Δ) in COx and cardiac output (QT), respectively.
Results
There were no significant between‐intervention differences in peak work rate, ventilation and reported symptoms (P>0·05). Peripheral oxyhaemoglobin saturation remained above 98% throughout the tests. NIV + HOx was associated with larger increases in Δ COx, Δ QT and Δ stroke volume at maximal and submaximal exercise (P<0·05). Increases in the area under the curve (to an iso‐work rate) of Δ COx under NIV + HOx were significantly (P<0·01) correlated with improvements in Δ QT (r = 0·82) and Δ stroke volume (r = 0·87). There was, however, no significant correlation between enhancement in these physiological responses with changes in peak work rate with NIV + HOx (P>0·05).
Conclusions
NIV added benefit to HOx in improving central haemodynamics and COx in O2 ‘desaturators’ with COPD. The clinical relevance of such beneficial effects on exercise tolerance, however, remains to be demonstrated.</description><subject>Aged</subject><subject>Brazil</subject><subject>Cardiac Output</subject><subject>Cardiography, Impedance</subject><subject>cerebral oxygenation</subject><subject>Cerebrovascular Circulation</subject><subject>chronic obstructive pulmonary disease</subject><subject>Double-Blind Method</subject><subject>Exercise</subject><subject>Exercise Tolerance</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Hypoxia - blood</subject><subject>Hypoxia - physiopathology</subject><subject>Lung - physiopathology</subject><subject>lung physiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>near-infrared spectroscopy</subject><subject>non-invasive ventilation</subject><subject>Noninvasive Ventilation - methods</subject><subject>Oxygen - blood</subject><subject>Oxygen Consumption</subject><subject>Positive-Pressure Respiration</subject><subject>Pulmonary Disease, Chronic Obstructive - blood</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary Disease, Chronic Obstructive - therapy</subject><subject>Spectroscopy, Near-Infrared</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1475-0961</issn><issn>1475-097X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1y0zAUhTUMDC2BBS_AaIYNG7f6V7wshhZmCukCptlpZOuKqji2kew0eQMeGyUpWbBCG90jfefekQ5Cryk5o3mdN4M_o4ww8QSdUqFlQUq9fHqsFT1BL1K6J4RqLvRzdMK4Kpmi6hT9vnAujGENGLyHZky497jruyJ0a5t252voxtDaMfQdHnt8tx0g9ptgcdYNRKijbXG_2f6A7gCFDleLmw94yDJ7E34I4x2GDcQmJCgi5Gbg8IJhB8mOU9zbXqJn3rYJXj3uM_T98uO36lNxvbj6XF1cF4FLIgoh506VvuQEBGm4U94xMuecWy7nXpayVpQz5pWombV2LmrQJfi6dvOsneYz9O7Qd4j9rwnSaFYhNdC2toN-SoZyzRST-XP-A5VCl0Tm8TP09h_0vp9ilx-yozjXgnOSqTeP1FSvwJkhhpWNW_M3jgycH4CH0ML2eE-J2eVscs5mn7Opbi73RXYUB0dII2yODht_GqW5lub265Uh1Xu1XH65NRX_A76VqkI</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Rodrigues, Miguel K.</creator><creator>Oliveira, Mayron F.</creator><creator>Soares, Aline</creator><creator>Treptow, Erika</creator><creator>Neder, J Alberto</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7TS</scope><scope>7U5</scope><scope>8FD</scope><scope>K9.</scope><scope>L7M</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>201307</creationdate><title>Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation</title><author>Rodrigues, Miguel K. ; Oliveira, Mayron F. ; Soares, Aline ; Treptow, Erika ; Neder, J Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i3504-458d69f930e40c3d6fd208333a358f595b61322f64b2aaa84be79efbbd82aad73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Brazil</topic><topic>Cardiac Output</topic><topic>Cardiography, Impedance</topic><topic>cerebral oxygenation</topic><topic>Cerebrovascular Circulation</topic><topic>chronic obstructive pulmonary disease</topic><topic>Double-Blind Method</topic><topic>Exercise</topic><topic>Exercise Tolerance</topic><topic>Forced Expiratory Volume</topic><topic>Humans</topic><topic>Hypoxia - blood</topic><topic>Hypoxia - physiopathology</topic><topic>Lung - physiopathology</topic><topic>lung physiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>near-infrared spectroscopy</topic><topic>non-invasive ventilation</topic><topic>Noninvasive Ventilation - methods</topic><topic>Oxygen - blood</topic><topic>Oxygen Consumption</topic><topic>Positive-Pressure Respiration</topic><topic>Pulmonary Disease, Chronic Obstructive - blood</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Pulmonary Disease, Chronic Obstructive - therapy</topic><topic>Spectroscopy, Near-Infrared</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodrigues, Miguel K.</creatorcontrib><creatorcontrib>Oliveira, Mayron F.</creatorcontrib><creatorcontrib>Soares, Aline</creatorcontrib><creatorcontrib>Treptow, Erika</creatorcontrib><creatorcontrib>Neder, J Alberto</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Technology Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Clinical physiology and functional imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodrigues, Miguel K.</au><au>Oliveira, Mayron F.</au><au>Soares, Aline</au><au>Treptow, Erika</au><au>Neder, J Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation</atitle><jtitle>Clinical physiology and functional imaging</jtitle><addtitle>Clin Physiol Funct Imaging</addtitle><date>2013-07</date><risdate>2013</risdate><volume>33</volume><issue>4</issue><spage>274</spage><epage>281</epage><pages>274-281</pages><issn>1475-0961</issn><eissn>1475-097X</eissn><coden>CPFICA</coden><abstract>Summary
Background
It is currently unknown whether potential haemodynamic improvements induced by non‐invasive ventilation (NIV) would positively impact upon cerebral oxygenation (COx) in patients with moderate‐to‐severe chronic obstructive pulmonary disease (COPD).
Objective
To investigate the effects of NIV on exercise COx in COPD patients presenting with exercise‐related O2 desaturation.
Methods
On a double‐blind trial, 13 males (FEV1 = 48·8 ± 15·1% predicted) were randomly assigned to NIV (16 cmH2O IPS and 5 cmH2O PEEP) plus HOx (FiO2 = 0·4) or sham NIV (7 cmH2O IPS and 5 cmH2O PEEP to overcome breathing circuit resistance) plus HOx during ramp‐incremental exercise performed on different days. Near‐infrared spectroscopy and impedance cardiography assessed changes (Δ) in COx and cardiac output (QT), respectively.
Results
There were no significant between‐intervention differences in peak work rate, ventilation and reported symptoms (P>0·05). Peripheral oxyhaemoglobin saturation remained above 98% throughout the tests. NIV + HOx was associated with larger increases in Δ COx, Δ QT and Δ stroke volume at maximal and submaximal exercise (P<0·05). Increases in the area under the curve (to an iso‐work rate) of Δ COx under NIV + HOx were significantly (P<0·01) correlated with improvements in Δ QT (r = 0·82) and Δ stroke volume (r = 0·87). There was, however, no significant correlation between enhancement in these physiological responses with changes in peak work rate with NIV + HOx (P>0·05).
Conclusions
NIV added benefit to HOx in improving central haemodynamics and COx in O2 ‘desaturators’ with COPD. The clinical relevance of such beneficial effects on exercise tolerance, however, remains to be demonstrated.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23692616</pmid><doi>10.1111/cpf.12024</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Brazil Cardiac Output Cardiography, Impedance cerebral oxygenation Cerebrovascular Circulation chronic obstructive pulmonary disease Double-Blind Method Exercise Exercise Tolerance Forced Expiratory Volume Humans Hypoxia - blood Hypoxia - physiopathology Lung - physiopathology lung physiology Male Middle Aged near-infrared spectroscopy non-invasive ventilation Noninvasive Ventilation - methods Oxygen - blood Oxygen Consumption Positive-Pressure Respiration Pulmonary Disease, Chronic Obstructive - blood Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Disease, Chronic Obstructive - therapy Spectroscopy, Near-Infrared Time Factors Treatment Outcome |
| title | Additive effects of non-invasive ventilation to hyperoxia on cerebral oxygenation in COPD patients with exercise-related O2 desaturation |
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