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Abnormal Exercise Responses in Survivors of Acute Lung Injury During Cardiopulmonary Exercise Testing

AN OBSERVATIONAL STUDY

Mackney, Jennifer BAppSc (Physiotherapy), MClinEd; Harrold, Meg PhD; Jenkins, Sue PhD; Havill, Ken MBBS, FRACP, CICM; Hill, Kylie PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: July 2019 - Volume 39 - Issue 4 - p E16–E22
doi: 10.1097/HCR.0000000000000432
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Purpose: This study compared exercise responses in individuals who had recently survived an admission to the intensive care unit for acute lung injury (ALI) with healthy controls.

Methods: Ten patients with ALI were recruited at 2 Australian hospitals. Six weeks after hospital discharge, participants completed lung function measures and a laboratory-based cardiopulmonary exercise test. Identical measures were collected in 21 healthy participants of similar age and gender distribution.

Results: Compared with the healthy participants, the ALI participants were similar in age (51 ± 14 vs 50 ± 16 yr), with a lower peak oxygen uptake (

O2) (median [interquartile range], 31.80 [26.60-41.73] vs 17.80 [14.85-20.85] mL/kg/min; P < .01) and higher ventilatory equivalent for carbon dioxide (

E/

CO2) at anaerobic threshold (mean ± SD, 25.7 ± 2.5 vs 35.2 ± 4.1; P < .01). Analysis of individual ALI participant responses showed that 8 participants had a decreased peak

O2 and anaerobic threshold. All ALI participants were limited by leg fatigue. Abnormalities of pulmonary gas exchange were present in 7 participants. Evidence of cardiac ischemia was present in 2 participants.

Conclusions: Compared with healthy controls, ALI participants had reduced exercise capacity, mainly due to profound deconditioning. Exercise training to optimize aerobic capacity would appear to be a rehabilitation priority in this population.

Ten patients who had recently survived an admission to the intensive care unit for acute lung infection (ALI), completed a symptom-limited cardiopulmonary exercise test. Compared with 21 healthy controls, the ALI participants had reduced exercise capacity, mainly due to profound deconditioning. Exercise training to optimize aerobic capacity would appear to be a rehabilitation priority.

School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia (Ms Mackney and Drs Harrold, Jenkins, and Hill); School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia (Ms Mackney); Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia (Ms Mackney); Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Australia (Dr Jenkins); Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia (Drs Jenkins and Hill); and Department of Intensive Care, John Hunter Hospital, New Lambton Heights, Australia (Mr Havill).

Correspondence: Jennifer Mackney, BAppSc (Physiotherapy), MClinEd, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia (Jennifer.Mackney@newcastle.edu.au).

All authors declare no conflicts of interest.

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