Non-invasive ventilation during cycle exercise training in patients with chronic respiratory failure on long-term ventilatory support: A randomized controlled trial
Non-invasive ventilation during cycle exercise training in patients with chronic respiratory failure on long-term ventilatory support: A randomized controlled trial
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DOI：
10.1111/resp.13181
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发表时间：
2018-02-01
期刊：
影响因子：
6.9
通讯作者：
Paneroni, Mara
中科院分区：
文献类型：
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作者：
Vitacca, Michele;Kaymaz, Dicle;Paneroni, Mara
背景与目的无创通气（NIV）在慢性呼吸衰竭（CRF）患者运动训练（ET）中的作用尚不清楚。本研究的目的是测试与单独ET相比，在ET期间进行NIV是否对增加6分钟步行距离（6MWD）和循环耐力时间有额外的影响。方法所有患者均接受为期3周的20次周期训练，随机分配到ET联合NIV组或单独ET组。结果测量为6MWD（主要结果）、增加和耐力周期运动时间、呼吸肌功能、Maugeri呼吸衰竭问卷（MRF-28）的生活质量、呼吸困难（医学研究委员会量表）和休息时腿部疲劳。结果42例患者完成了研究。训练后，组间6MWD变化无显著差异。与非NIV训练组相比，NIV组耐力时间的改善明显更大（754973 vs 51 +/- 406s， P=0.0271）；两组呼吸困难均有改善，而呼吸肌功能和腿部疲劳仅在NIV ET组有所改善。MRF-28仅在没有NIV的组训练中有所改善。结论在长期无氧治疗（NIV）和长期氧疗（LTOT）的CRF患者中，在ET疗程中增加无氧治疗可改善耐力时间，但对6MWD没有改善。
Background and objectiveThe role of non-invasive ventilation (NIV) during exercise training (ET) in patients with chronic respiratory failure (CRF) is still unclear. The aim of this study was to test whether NIV during ET had an additional effect in increasing the 6-min walking distance (6MWD) and cycle endurance time compared with ET alone.MethodsAll patients underwent 20 sessions of cycle training over 3weeks and were randomly assigned to ET with NIV or ET alone. Outcome measures were 6MWD (primary outcome), incremental and endurance cycle ergometer exercise time, respiratory muscle function, quality of life by the Maugeri Respiratory Failure questionnaire (MRF-28), dyspnoea (Medical Research Council scale) and leg fatigue at rest.ResultsForty-two patients completed the study. Following training, no significant difference in 6MWD changes were found between groups. Improvement in endurance time was significantly greater in the NIV group compared with the non-NIV training group (754973 vs 51 +/- 406s, P=0.0271); dyspnoea improved in both groups, while respiratory muscle function and leg fatigue improved only in the NIV ET group. MRF-28 improved only in the group training without NIV.Conclusion In CRF patients on long-term NIV and long-term oxygen therapy (LTOT), the addition of NIV to ET sessions resulted in an improvement in endurance time, but not in 6MWD.