Patient-ventilator Asychrony During Non-invasive Ventilation When COPD Patients Doing Exercise

Study Overview
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Brief Summary
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Pulmonary rehabilitation programmes including aerobic exercise training have strong evidence of effectiveness in improving exercise capacity, dyspnoea and HRQL in patients with COPD. Therefore, current guidelines recommend pulmonary rehabilitation, including exercise training, in these patients. Non-invasive ventilation(NIV) is increasingly used during exercise training programmes in order to train patients at intensity levels higher than allowed by their clinical and pathophysiological conditions. Patient-ventilator asynchrony (PVA) describes the poor interaction between the patient and the ventilator and is the consequence of the respiratory muscle activity of the patient being opposed to the action of the ventilator.PVA have unfavourable clinical impace on gas exchange, dyspnoea perception, patient comfort and tolerance and reduced adherence to NIV. This study is going to detect whether the PVA will increase when COPD patients exercise with NIV supporingt

Official Title
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Patient-ventilator Asychrony During Non-invasive Ventilation When COPD Patients Doing Exercise

Conditions
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COP, Non-invasive Ventilation, Pulmonary Rehabilitation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 40-80, males and females; Stage III and IV COPD; Similar with non-invasive ventilation; Willing to participate in the study; Able to provide informed consent. Exclusion Criteria: Presented with an acute exacerbation during previous 3 months; Bronchiectasis; post-tuberculosis sequelae; rib cage deformities; neuromuscular disorders; and bronchial carcinoma. Intolerant with NIV

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Asynchrony index | Asynchrony index is defined as the number of asynchrony events divided by the total respiratory rate computed as the sum of the number of ventilator cycles (triggered or not) and of wasted efforts: asynchrony Index (expressed in percentage) = number of asynchrony events/total respiratory rate (ventilator cycles +wasted efforts) × 100 | 5 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Severe Respiratory Insufficiency (SRI) Questionnaire | The SRI Questionnaire has good psychometric properties shown to be valid for chronic hypercapnic COPD patients receiving NIV. It includes 49 items on seven subscales. | 5 hours | 
| COPD assessment test | The COPD Assessment Test is a questionnaire for people with COPD. It is designed to measure the impact of COPD on a person's life, and how this changes over time. | 5 hours | 
| Partial pressure of arterial blood carbon dioxide (PaCO2) | Daytime arterial blood gas samples were taken with patients resting in a sitting position and breathing room air without having used NIV for at least 1 hour. | 5 hours | 
| 6-minute walk test | The 6-minute walk test plays a key role in evaluating functional exercise capacity, assessing prognosis and evaluating response to treatment across a wide range of respiratory diseases | 5 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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patient-ventilator asynchrony