title: Non-invasive ventilation (NIV) as an aid to rehabilitation in acute respiratory disease.
abstract: BACKGROUND
  Non-invasive ventilation (NIV) can increase exercise tolerance, reduce exercise induced desaturation and improve the outcome of pulmonary rehabilitation in patients with chronic respiratory disease. It is not known whether it can be applied to increase exercise capacity in patients admitted with non-hypercapnic acute exacerbations of COPD (AECOPD). We investigated the acceptability and feasibility of using NIV for this purpose.
  
  
  METHODS
  On a single occasion, patients admitted with an acute exacerbation of chronic respiratory disease who were unable to cycle for five minutes at 20 watts attempted to cycle using NIV and their endurance time (T(lim)) was recorded. To determine feasibility of this approach in clinical practice patients admitted with AECOPD were screened for participation in a trial of regular NIV assisted rehabilitation during their hospital admission.
  
  
  RESULTS
  In 12 patients tested on a single occasion NIV increased T(lim) from 184(65) seconds to 331(229) seconds (p = 0.04) and patients desaturated less (median difference = 3.5%, p = 0.029). In the second study, 60 patients were admitted to hospital during a three month period of whom only 18(30)% were eligible to participate and of these patients, only four (7%) consented to participate.
  
  
  CONCLUSIONS
  NIV improves exercise tolerance in patients with acute exacerbations of chronic respiratory disease but the applicability of this approach in routine clinical practice may be limited.
  
  
  BACKGROUND
  http://www.controlled-trials.com/ISRCTN35692743.
authors.affiliation: The NIHR Respiratory Biomedical Research Unit at Royal Brompton, London, UK.
authors.forename: Fran
authors.initials: F
authors.lastname: Dyer
authors.forename: Lizzie
authors.initials: L
authors.lastname: Flude
authors.forename: Farid
authors.initials: F
authors.lastname: Bazari
authors.forename: Caroline
authors.initials: C
authors.lastname: Jolley
authors.forename: Catherine
authors.initials: C
authors.lastname: Englebretsen
authors.forename: Dilys
authors.initials: D
authors.lastname: Lai
authors.forename: Michael I
authors.initials: MI
authors.lastname: Polkey
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hopkinson
mesh_terms: D000208:Acute Disease; D017079:Exercise Tolerance; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation / Q000628:therapy*