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[Spiroergometry in patients with severe chronic obstructive pulmonary disease confined to bed]
W Galetke1, W Randerath, M Pfeiffer
1Klinik Ambrock, Hagen (Prof. Dr. med. Karl-Heinz Rühle) Klinik für Pneumologie, Allergologie und Schlafmedizin, Universität Witten/Herdecke. wohegal@t-online.de
Background:
Exercise training is recommended for patients with severe chronic obstructive pulmonary disease (COPD) to improve the endurance capacity. While many patients confined to bed are not able to run exercise training, we investigated the influence of a bedside passive-ergometry on ventilation in patients with severe COPD.
Methods:
In nine patients with severe COPD confined to bed (FEV1.0 0,94 +/- 0,18 l, IVC 2,3 +/- 0,8 l, Raw 0,91 +/- 0,13 kPa/l/s) we measured oxygen uptake O2, breathing frequency BF and minute ventilation E during rest, passive movement (30 revolutions per minute), additional active movement and maximal exercise. As a control group six healthy men were investigated during rest and passive movement.
Results:
During maximal exercise in COPD patients O2 peak reached 618 +/- 177 ml/min, BF 26 +/- 7,2/min and E max 24,1 +/- 5 l/min. In rest O2 was 311 +/- 56 ml/min (53 % O2 peak), BF 17,6 +/- 3,1/min and E 13,3 +/- 2,7 ml/min (55 % E max), while during passive movement O2 was increased to 369 +/- 88 (62 % O2 peak), BF to 19 +/- 5,3 and E to 16,4 +/- 4,1 (68 % E max). In contrast O2 in control subjects dropped from 377,5 +/- 38 in rest to 336 +/- 27 ml/min during passive action, BF from 14 +/- 2,1 to 12 +/- 2,4/min and E from 11,1 +/- 1,3 to 9,1 +/- 1 ml/min.
Conclusions:
In patients with severe COPD oxygen uptake, breathing frequency and minute ventilation increased not only during active, but even during passive movement of a bedside ergometer. With this method an exercise training is possible even in COPD patients confined to bed.