Effect of Breathing Oxygen-Enriched Air on Exercise Performance in Patients with Chronic Obstructive Pulmonary Disease: Randomized, Placebo-Controlled, Cross-Over Trial
Effect of Breathing Oxygen-Enriched Air on Exercise Performance in Patients with Chronic Obstructive Pulmonary Disease: Randomized, Placebo-Controlled, Cross-Over Trial
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DOI：
10.1159/000505819
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发表时间：
2020-03-01
期刊：
影响因子：
3.7
通讯作者：
Ulrich, Silvia
中科院分区：
文献类型：
--
作者：
Hasler, Elisabeth Domenica;Saxer, Stephanie;Ulrich, Silvia
背景：慢性阻塞性肺疾病(COPD)患者在运动过程中会出现呼吸困难和低氧血症。目的：探讨呼吸富氧空气对慢性阻塞性肺疾病(COPD)患者运动能力及相关生理改变的影响。方法：采用随机、安慰剂对照、单盲、交叉试验的方法，对20例慢性阻塞性肺疾病患者(11例女性，年龄65+/-6岁，FEV1FEV1FEV1+/-19%，静息SpO(2)+Gt；=90%)分别进行4个循环的递增负荷运动试验(IET)和恒定负荷运动试验(CWRET)，分别采用常温(FiO(2)0.21)和富氧(FiO(2)0.5)空气。主要结果是IET中最大负荷的变化和CWRET中氧气与空气的运动持续时间的变化。此外，还测量了心电图、肺气体交换、电感体积描记仪的胸腔容量、动脉血气、大脑和股四头肌组织氧合(CTO和MTO)。结果：吸氧后最大负荷由96+/-21 W增加到104+/-28 W。在CWRET中，有氧运动时间从605+/-274增加到963+/-444 S。有氧运动结束时，CTO、MTO、PaO2和PaCO2升高，而V‘e/V’CO2降低，胸腔容量相似。在环境空气中运动结束的相应时间，氧气降低了心率、呼吸频率、每分钟通气量和V‘e/V’CO2，而氧合增加。结论：在无静息性低氧血症的COPD患者中，呼吸富氧空气可提高运动能力。这与较高的动脉血氧饱和度、促进肌肉和脑组织的氧气供应以及提高通风效率有关。慢性阻塞性肺疾病患者可以在运动训练中受益于氧疗。
Background: Patients with chronic obstructive pulmonary disease (COPD) experience dyspnea and hypoxemia during exercise. Objective: The aim of this study was to evaluate the effects of breathing oxygen-enriched air on exercise performance and associated physiological changes in patients with COPD. Methods: In a randomized, placebo-controlled, single-blind, cross-over trial, 20 patients with COPD (11 women, age 65 +/- 6 years, FEV1 64 +/- 19% pred., resting SpO(2) >= 90%) performed 4 cycle ergospirometries to exhaustion using an incremental exercise test (IET) and a constant work rate (at 75% maximal workload with air) exercise test (CWRET), each with ambient (FiO(2) 0.21) and oxygen-enriched (FiO(2) 0.5) air. The main outcomes were the change in maximal workload in the IET and the change in exercise duration in the CWRET with oxygen versus air. Electrocardiogram, pulmonary gas exchange, thoracic volumes by inductance plethysmography, arterial blood gases, and cerebral and quadriceps muscle tissue oxygenation (CTO and MTO) were additionally measured. Results: In the IET, maximal workload increased from 96 +/- 21 to 104 +/- 28 W with oxygen. In the CWRET, exercise duration increased from 605 +/- 274 to 963 +/- 444 s with oxygen. At end-exercise with oxygen, CTO, MTO, PaO2, and PaCO2 were increased, while V'E/V'CO2 was reduced and thoracic volumes were similar. At the corresponding time to end of exercise with ambient air, oxygen decreased heart rate, respiratory rate, minute ventilation, and V'E/V'CO2, while oxygenation was increased. Conclusion: In COPD patients without resting hypoxemia, breathing oxygen-enriched air improves exercise performance. This relates to a higher arterial oxygen saturation promoting oxygen availability to muscle and cerebral tissue and an enhanced ventilatory efficiency. COPD patients may benefit from oxygen therapy during exercise training.