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Noninvasive ventilatory assistance during exercise for patients with kyphoscoliosis: a pilot study
Vila B, Servera E, Marin J, Diaz J, Gimenez M, Komaroff E, Bach J
American Journal of Physical Medicine & Rehabilitation 2007 Aug;86(8):672-677
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cmH2O) plus positive end expiratory pressure (PEEP) (4 cmH2O) via a nasal mask. Of the compared parameters, heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 versus 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 versus 69.5 +/- 15.7 mmHg), and hypercapnia (PaCO2 = 54.3 +/- 7.6 versus 47.1 +/- 7.1 mmHg) were significantly greater for the SBT than for the NIVT (p < 0.05). The hypercapnia and hypoxia for the NIVT were not significantly greater than preexercise resting levels. Dyspnea and perceived effort were significantly greater for the SBT (p < 0.05). In conclusion, NIV can improve clinical and physiologic response to exercise.

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