Positive end-expiratory pressure attenuates hemodynamic effects induced by an overload of inspiratory muscles in patients with COPD

Autor: Schaper-Magalhães F, Pinho JF, Capuruço CAB, Rodrigues-Machado MG
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: International Journal of COPD, Vol Volume 12, Pp 2943-2954 (2017)
Druh dokumentu: article
ISSN: 1178-2005
Popis: Flavia Schaper-Magalhães,1 José Felippe Pinho,1 Carolina Andrade Bragança Capuruço,2 Maria Glória Rodrigues-Machado1 1Medical Sciences Faculty of Minas Gerais, Post-Graduation Program in Health Sciences, Belo Horizonte, Brazil; 2Department of Cardiology, Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil Background: Inspiratory muscle training (IMT) using a Threshold® device is commonly used to improve the strength and endurance of inspiratory muscles. However, the effect of IMT, alone or with positive end-expiratory pressure (PEEP), on hemodynamic parameters in patients with chronic obstructive pulmonary disease (COPD) remains unknown.Objective: To assess the effects of an overload of inspiratory muscles using IMT fixed at 30% of the maximal inspiratory pressure (MIP), and IMT associated with 5 cmH2O of PEEP (IMT + PEEP), on the echocardiographic parameters in healthy subjects and patients with COPD.Methods: Twenty patients with COPD (forced expiratory volume in 1 second 53.19±24.71 pred%) and 15 age-matched healthy volunteers were evaluated using spirometry, MIP, the COPD assessment test (CAT), and the modified Medical Research Council (mMRC) dyspnea scale. The E- (fast-filling phase) and A- (atrial contraction phase) waves were evaluated at the tricuspid and mitral valves during inspiration and expiration in the following sequence: at basal conditions, using IMT, and using IMT + PEEP.Results: Patients with COPD had reduced MIPs versus the control group. Ten patients had CAT scores
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