在运动训练期间高强度非侵入性通风与在非常严重的COPD和慢性超性呼吸衰竭患者中没有高强度非侵入性通风:一项随机对照试验
Tessa Schneeberger1,2, Clancy John Dennis3,4, Inga Jarosch5,2
1Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany tessa.schneeberger@staff.uni-marburg.de.
BMJ open respiratory research
|November 22, 2023
概括
在运动训练 (ET) 期间的高强度非侵入性通风 (HI-NIV) 并没有显著改善严重COPD患者的运动能力. 然而,HI-NIV确实可以减少运动期间呼吸障碍,大多数患者更喜欢这种方法.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统生理学 呼吸系统生理学
- 康复科学 康复科学 康复科学
背景情况:
- 患有非常严重的慢性阻塞性肺病 (COPD) 和慢性超性呼吸衰竭 (CHRF) 的患者经常经历运动能力降低和严重呼吸不良.
- 夜间非侵入性通风 (NIV) 被用于管理CHRF,但其在炼训练 (ET) 期间在肺康复 (PR) 中对这些患者的作用尚不清楚.
- 在ET期间高强度NIV (HI-NIV) 可能会个性化训练,但其在极限患者中的接受度和有效性仍然未知.
研究的目的:
- 调查在PR期间与HI-NIV结合的ET是否比单独的ET更有效地提高运动能力.
- 评估HI-NIV在ET期间对减轻严重COPD患者呼吸障碍的影响.
- 为了确定患者对使用或不使用HI-NIV进行运动的偏好.
主要方法:
- 一项随机对照试验,涉及26名患有COPD,CHRF和夜间NIV的参与者.
- 参与者被分配到受监督的ET循环中,作为HI-NIV或没有HI-NIV的PR的一部分 (对照组).
- 主要结局是周期耐力时间 (ΔCETtime) 的变化;次要结局包括呼吸障碍水平和首选的炼方法.
主要成果:
- 在HI-NIV和对照组之间没有观察到 ΔCET 时间的显著差异.
- 两组都在CETtime中表现出显著的集团内部改善,两组的受访者比例相似.
- 与对照组相比,HI-NIV组在耐力测试和ET会议期间报告呼吸障碍明显减少.
- 大多数HI-NIV组 (12/13) 的人更喜欢使用NIV进行炼.
结论:
- 在PR期间的运动训练显著提高了需要夜间NIV的非常严重COPD患者的运动能力,而不管HI-NIV使用.
- 在这个人群中,在ET期间使用HI-NIV并没有提高运动能力,但与呼吸障碍的减少有关.
- 大多数HI-NIV组的患者更喜欢与NIV一起炼,这表明对坚持和舒适的潜在好处.
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