%0 Journal Article
%T Non-invasive ventilation (NIV) as an aid to rehabilitation in acute respiratory disease
%A Fran Dyer
%A Lizzie Flude
%A Farid Bazari
%A Caroline Jolley
%A Catherine Englebretsen
%A Dilys Lai
%A Michael I Polkey
%A Nicholas S Hopkinson
%J BMC Pulmonary Medicine
%D 2011
%I BioMed Central
%R 10.1186/1471-2466-11-58
%X 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 (Tlim) 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.In 12 patients tested on a single occasion NIV increased Tlim 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.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.http://www.controlled-trials.com/ISRCTN35692743 webciteExercise limitation is a cardinal feature of COPD which is particularly marked in patients who require hospital admission. It is directly related to skeletal muscle weakness [1-3] and quadriceps weakness is associated with increased mortality in COPD [4]. Patients with low physical activity levels are more likely to be admitted to hospital [5] and exacerbations themselves lead to a dramatic reduction in physical activity [6] and health status [7] which can be prolonged, reflected in reduced time spent outdoors [8]. Activity limitation is also associated with a greater likelihood of relapse after discharge following accident and emergency department attendance [9].Although muscle weakness is multifactorial, disuse is likely to be the major reversible factor with loss of strength most pronounced in the muscles of locomotion [10]. In healthy older people 10 days bed rest produces a 20% fall in quadriceps strength [11]. An acute fall i
%U http://www.biomedcentral.com/1471-2466/11/58