A study in Chest evaluated the impact of noninvasive ventilation during exercise in patients with severe COPD.

“Bilevel noninvasive ventilation during exercise may provide greater benefits to people with dynamic hyperinflation than does noninvasive ventilation with inspiratory pressure support alone or techniques that provide only positive expiratory pressure by combining the beneficial effects of positive inspiratory and expiratory pressures,”Clancy J. Dennis, BEngwith the faculty of medicine and health at the University of Sydney, and colleagues wrote. “However, the effect on dynamic hyperinflation of bilevel noninvasive ventilation during exercise is unknown.”

The randomized, crossover trial included 19 participants with COPD (mean age, 69 years; 57.8% men) and an FEV1/FVC of less than 0.7, an FEV1 of less than 50% predicted, resting hyperinflation with residual volume/total lung capacity of more than 110% predicted, no exacerbations in the past 4 weeks and dynamic hyperinflation during a peak incremental cycle test. All participants completed three constant work rate endurance cycle tests in a random order of no noninvasive ventilation, noninvasive ventilation with standardized expiratory positive airway pressure and noninvasive ventilation with titrated expiratory positive airway pressure during exercise.

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