Can non-invasive ventilation modulate cerebral, respiratory, and peripheral muscle oxygenation during high-intensity exercise in patients with COPD-HF?

• Autor(a) principal: Goulart, Cássia da Luz
• Data de Publicação: 2022
• Outros Autores: Caruso, Flávia Rossi, Araújo, Adriana Sanches Garcia de, Moura, Silvia Cristina Garcia de, Catai, Aparecida Maria, Agostoni, Piergiuseppe, Mendes, Renata Gonçalves, Arena, Ross, Silva, Audrey Borghi
• Tipo de documento: Conjunto de dados
• Idioma: eng
• Título da fonte: Repositório Institucional da UFSCAR
• Texto Completo: https://doi.org/10.3389/fcvm.2021.772650; https://repositorio.ufscar.br/handle/ufscar/15576
• topic: Blood flow muscle; Heart failure; COPD; Cardiovascular physiology; Oxygen consumption; CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Aim: To evaluate the effect of non-invasive positive pressure ventilation (NIPPV) on (1) metabolic, ventilatory, and hemodynamic responses; and (2) cerebral (Cox), respiratory, and peripheral oxygenation when compared with SHAM ventilation during the high-intensity exercise in patients with coexisting chronic obstructive pulmonary disease (COPD) and heart failure (HF). Methods and Results: On separate days, patients performed incremental cardiopulmonary exercise testing and two constant-work rate tests receiving NIPPV or controlled ventilation (SHAM) (the bilevel mode—Astral 150) in random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin (OxyHb+Mb) and deoxyhemoglobin (DeoxyHb+Mb) were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, The Netherlands). NIPPV associated with high-intensity exercise caused a significant increase in exercise tolerance, peak oxygen consumption (V⋅O2 in mlO2·kg−1·min−1), minute ventilation peak (V⋅E in ml/min), peak peripheral oxygen saturation (SpO2, %), and lactate/tlim (mmol/s) when compared with SHAM ventilation. In cerebral, respiratory, and peripheral muscles, NIPPV resulted in a lower drop in OxyHb+Mb (p < 0.05) and an improved deoxygenation response DeoxyHb+Mb (p < 0.05) from the half of the test (60% of Tlim) when compared with SHAM ventilation. Conclusion: Non-invasive positive pressure ventilation during constant work-rate exercise led to providing the respiratory muscle unloading with greater oxygen supply to the peripheral muscles, reducing muscle fatigue, and sustaining longer exercise time in patients with COPD-HF.