Four-week negative pressure ventilation improves respiratory function in severe hypercapnic COPD patients.

Content Provider	Semantic Scholar
Author	Gigliotti, Francesco Spinelli, Aureliano Duranti, Roberto Gorini, Massimo Goti, P. Scano, Giuseppina
Copyright Year	1994
Abstract	Studies on respiratory muscle resting by negative pressure ventilation (NPV) in patients with stable COPD have given conflicting results. Probable explanations lie in criteria of patients' selection, method of NPV application, and lack of supervision of respiratory muscle rest. Thirteen hypercapnic patients with COPD were, therefore, randomly assigned to either a NPV group or a control group. The NPV was applied by an airtight jacket (pneumosuit), 5 h a day, 5 consecutive days a week for 4 weeks. Both NPV group and control group performed in-hospital pulmonary rehabilitation program for a 4-week period. Arterial blood gases, spirometry, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), breathing pattern, and electromyogram (EMG) of the diaphragm and parasternal intercostal muscles were measured on the preintervention day, and at the end of the second and fourth weeks of treatment (days 13 and 27, respectively). The short-term effect of NPV on EMG suppression was also checked throughout the ventilatory sessions in three different days (1, 12, and 26, respectively). A 6-min walking test (WT) and level of dyspnea by a modified Borg scale were evaluated on the preintervention and the last days. Negative pressure ventilation resulted in a significant reduction in EMG activity of both diaphragm and parasternal muscles, associated with significant increase in MIP, tidal volume, and ventilation, and increase in PaO2 and decrease in PaCO2. A significant relationship between change in MIP and change in PaCO2 was observed (r = 0.72, p < 0.01). Improve-ment in 6-min WT and dyspnea sensation was also observed, both being the sole changes in the control group. These data seem to indicate a beneficial role of respiratory muscle rest in improving respiratory function. Adequate supervision by personnel familiar with the equipment is likely to contribute to successful treatment.
Starting Page	87
Ending Page	94
Page Count	8
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21688/87.pdf
PubMed reference number	8275793v1
Volume Number	105
Issue Number	1
Journal	Chest
Language	English
Access Restriction	Open
Subject Keyword	Checking (action) Chronic Obstructive Airway Disease Control Groups Dyspnea Electromyography Expiration, function Gases Idiopathic Pulmonary Fibrosis Inspiration function Maximal Expiratory Pressure Test Maximal Inspiratory Pressure Test Nucleopolyhedrovirus Oxygen measurement, partial pressure, arterial Patients PersonNameUse - assigned Rehabilitation therapy Respiration Respiratory Distress Syndrome, Newborn Respiratory Muscles Respiratory physiology Sensation Disorders Spirometry Structure of intercostal muscle explanation
Content Type	Text
Resource Type	Article