Departamento de Fisioterapia, Curso de Fisioterapia da Universidade Federal da Bahia - UFBA, Salvador, BA, Brazil; Programa de Pós Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil.
Departamento de Fisioterapia, Curso de Fisioterapia da Universidade Federal da Bahia - UFBA, Salvador, BA, Brazil.
Hellenic J Cardiol. 2018 Nov-Dec;59(6):317-320. doi: 10.1016/j.hjc.2017.11.005. Epub 2017 Nov 21.
Heart failure (HF) is a syndrome that results in inadequate blood supply, leading to a number of structural and functional changes. Noninvasive ventilatory support (NIVS) is used as an adjuvant treatment to improve the functional capacity of these patients.
To investigate the effect of NIVS with bilevel positive airway pressure ventilation (BiPAP) on exercise tolerance and dyspnea in HF patients.
Forty patients with New York Heart Association class I/II/III HF were randomly assigned either to a NIVS group (n = 20) or control group (n = 20). All patients underwent two 6-min walk tests (6MWT), with a 30-min interval between them. In the NIVS group, the patients performed the BiPAP with an inspiratory positive airway pressure of 12 cmHO and expiratory positive airway pressure of 6 cmHO for 30 min. At baseline, and after the first and second 6MWT, the heart rate, systolic and diastolic blood pressure, peripheral oxygen saturation (SaO), and dyspnea were evaluated.
Forty patients completed the study safely according to the randomization protocol, and no adverse events were reported during the tests. The NIVS group showed a significant improvement in the 6MWT distance (68.3 vs. 9.8 m) and dyspnea (1.3 vs. 3.1) compared with the control group. No serious adverse events were reported.
NIVS/BiPAP showed beneficial effects on exercise tolerance and dyspnea. It was safe and well tolerated by HF patients and should be considered for inclusion in cardiac rehabilitation programs.
心力衰竭（HF）是一种导致血液供应不足的综合征，导致许多结构和功能变化。无创通气支持（NIVS）被用作辅助治疗，以改善这些患者的功能能力。
研究双水平气道正压通气（BiPAP）无创通气支持对心力衰竭患者运动耐量和呼吸困难的影响。
40 名纽约心脏协会心功能分级 I/II/III 级的心力衰竭患者被随机分为 NIVS 组（n=20）或对照组（n=20）。所有患者均进行两次 6 分钟步行试验（6MWT），两次之间间隔 30 分钟。在 NIVS 组中，患者接受 BiPAP 治疗，吸气气道正压为 12cmH2O，呼气气道正压为 6cmH2O，持续 30 分钟。在基线时、第一次和第二次 6MWT 后，评估心率、收缩压和舒张压、外周血氧饱和度（SaO）和呼吸困难。
根据随机分组方案，40 例患者安全完成研究，在测试过程中未报告不良事件。与对照组相比，NIVS 组 6MWT 距离（68.3 比 9.8m）和呼吸困难（1.3 比 3.1）显著改善。未报告严重不良事件。
NIVS/BiPAP 对运动耐量和呼吸困难有有益的影响。它对心力衰竭患者是安全且耐受良好的，应考虑将其纳入心脏康复计划。
