The Use of Non-invasive Ventilation during Exercise Training in COPD Patients

Figures & data

Table 1. Potential mechanisms of NIV effect during exercise.

Setting	Mechanism
IPAP	WOB reduction; Respiratory muscle rest; Limb blood flow switch from respiratory to limb muscles; Anti-inflammatory action; Changes in vegetative status
PEEP or CPAP	Reduction in PEEPi

Abbreviations as in the text.

Table 2. Potential problems using NIV during exercise.

Source	Problem	Solution
Interfaces	Mouth breathing with nasal mask, increasing leaks	Full-face mask, mouthpiece
Comorbidities	Risk of exercising at loads higher than coronary ischaemic threshold	Careful pre-training clinical evaluation
Practicalities	Time required by physiotherapists; costs for professionals and equipment	Portable ventilators?

Table 3. Open questions for research using NIV during exercise.

Question	Aims of studies
Ideal candidate	Appropriate patient profile: COPD severity level and Patient's confidence level
Effective protocol	Comparing training alone, vs nocturnal NIV, and vs NIV under exercise
Outcome measures	tolerance to settings and equipment; incremental vs endurance test vs field tests; and HRQL vs dyspnoea vs daily life activities

Abbreviations as in the text.