Open Access Research article

Non-invasive ventilation (NIV) as an aid to rehabilitation in acute respiratory disease

Fran Dyer1, Lizzie Flude1, Farid Bazari1, Caroline Jolley1, Catherine Englebretsen2, Dilys Lai2, Michael I Polkey1 and Nicholas S Hopkinson1*

Author Affiliations

1 The NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London SW3 6NP UK

2 Chelsea and Westminster NHS Foundation Trust, 369, Fulham Rd, London SW10 9NH, UK

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BMC Pulmonary Medicine 2011, 11:58  doi:10.1186/1471-2466-11-58

Published: 16 December 2011

Abstract

Background

Non-invasive ventilation (NIV) can increase exercise tolerance, reduce exercise induced desaturation and improve the outcome of pulmonary rehabilitation in patients with chronic respiratory disease. It is not known whether it can be applied to increase exercise capacity in patients admitted with non-hypercapnic acute exacerbations of COPD (AECOPD). We investigated the acceptability and feasibility of using NIV for this purpose.

Methods

On a single occasion, patients admitted with an acute exacerbation of chronic respiratory disease who were unable to cycle for five minutes at 20 watts attempted to cycle using NIV and their endurance time (Tlim) was recorded. To determine feasibility of this approach in clinical practice patients admitted with AECOPD were screened for participation in a trial of regular NIV assisted rehabilitation during their hospital admission.

Results

In 12 patients tested on a single occasion NIV increased Tlim from 184(65) seconds to 331(229) seconds (p = 0.04) and patients desaturated less (median difference = 3.5%, p = 0.029). In the second study, 60 patients were admitted to hospital during a three month period of whom only 18(30)% were eligible to participate and of these patients, only four (7%) consented to participate.

Conclusion

NIV improves exercise tolerance in patients with acute exacerbations of chronic respiratory disease but the applicability of this approach in routine clinical practice may be limited.

Trial registration

http://www.controlled-trials.com/ISRCTN35692743 webcite