Ambrosino Nicolino, Cigni Paolo
Pulmonary Rehabilitation and Weaning Center, Auxilium Vitae, Borgo S.Lazzaro 5, Volterra, PI Italy.
Multidiscip Respir Med. 2015 Apr 9;10(1):14. doi: 10.1186/s40248-015-0008-1. eCollection 2015.
Recently, there has been increasing interest in the use of non invasive ventilation (NIV) to increase exercise capacity. In individuals with COPD, NIV during exercise reduces dyspnoea and increases exercise tolerance. Different modalities of mechanical ventilation have been used non-invasively as a tool to increase exercise tolerance in COPD, heart failure and lung and thoracic restrictive diseases. Inspiratory support provides symptomatic benefit by unloading the ventilatory muscles, whereas Continuous Positive Airway Pressure (CPAP) counterbalances the intrinsic positive end-expiratory pressure in COPD patients. Severe stable COPD patients undergoing home nocturnal NIV and daytime exercise training showed some benefits. Furthermore, it has been reported that in chronic hypercapnic COPD under long-term ventilatory support, NIV can also be administered during walking. Despite these results, the role of NIV as a routine component of pulmonary rehabilitation is still to be defined.
最近，人们对使用无创通气（NIV）来提高运动能力的兴趣日益增加。在慢性阻塞性肺疾病（COPD）患者中，运动期间进行无创通气可减轻呼吸困难并提高运动耐力。不同形式的机械通气已被无创地用作提高慢性阻塞性肺疾病、心力衰竭以及肺和胸廓限制性疾病患者运动耐力的工具。吸气支持通过减轻呼吸肌负荷提供症状改善，而持续气道正压通气（CPAP）可抵消慢性阻塞性肺疾病患者的内源性呼气末正压。接受家庭夜间无创通气和日间运动训练的重度稳定期慢性阻塞性肺疾病患者显示出了一些益处。此外，有报道称，在长期通气支持下的慢性高碳酸血症性慢性阻塞性肺疾病患者中，步行期间也可进行无创通气。尽管有这些结果，但无创通气作为肺康复常规组成部分的作用仍有待确定。
