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Ventilatory Support via Mouthpiece to Facilitate Ambulation

Pinto, Tiago C., PT, MSc1,2; Winck, João C., MD, PhD3; Gonçalves, Miguel R., PT, PhD1,2,3

American Journal of Physical Medicine & Rehabilitation: April 8, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001193
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Objective Evaluate the efficacy of noninvasive ventilatory assistance/support (NVS) via mouthpiece to improve performance in six-minute walk tests (6MWTs) for individuals with severe restrictive ventilatory disorders.

Design Each subject performed the 6MWT breathing spontaneously and again while using mouthpiece NVS at full ventilatory support. Oxyhemoglobin saturation (O2 sat), heart rate, Borg scale, distance walked and ambulation duration were recorded.

Results Eighteen patients using nocturnal nasal NVS, median (interquartile range) age 58.5 (20) years, were studied. Their median baseline forced vital capacity (FVC) and PaCO2 were 940 (385) ml and 54.1(6) mm Hg, respectively. All used NVS for at least overnight hours for 36 (111) months. Due to the progression of ventilatory impairment and hypercapnia, daytime mouthpiece NVS was initiated. All the 6MWT parameters improved significantly by using NVS. Both initial and final values of O2 sat significantly increased [92 (6) vs 96 (2)%, p<0.001] and [80 (19) vs 85.50 (13)%, p=0.001], respectively. Median distance walked increased by 43% with NVS [175 (218) vs 250 (113) m, p=0.017] and total ambulation time also increased with NVS [5.45 (3) vs. 6 (0) min, p=0.008].

Conclusions The exercise tolerance of patients with severe ventilatory impairment can improve by using noninvasive ventilatory support.

1Lung Function and Ventilation Unit – Pulmonary Medicine Department, Centro Hospitalar São João, Porto, Portugal

2I3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal

3Faculty of Medicine University of Porto, Portugal

Study Performed: Lung Function and Ventilation Unit – Pulmonary Medicine Department, Centro Hospitalar São João, Faculty of Medicine University of Porto, Portugal

Corresponding Author: Tiago C. Pinto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal, +351933367682, Email:tiagoffpinto@gmail.com

Author Disclosures: TP received a grant from Linde Healthcare to attend an international congress in order to present the data of this study. MRG received fees for academic and clinical lectures from Philips Respironics, Inc., ResMed, Inc., and Linde Healthcare. JCW declares no competing interests.

Preliminary Data previously presented:

Author: Tiago Pinto

Date/Conference: May, 15 to 20 of 2009 – American Thoracic Society International

Conference 2009, San Diego, CA, USA

Title: Mouthpiece Intermittent Volume Ventilation during Walking in Patients with Severe Restrictive Ventilatory Syndrome

Presentation Form: Poster Discussion

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