ABSTRACT
Objetivo: Evaluar el tratamiento combinado del comprehensive directed breathing con el programa de entrenamiento Square Wave Endurance Exercise Test en cicloergómetro con oxigenoterapia en el ejercicio en un paciente con EPOC grave, insuficiencia respiratoria crónica y agudización cardiorrespiratoria. Metodología: Se evalúa clínica y funcionalmente tras el alta médica a un paciente de 61 años con EPOC grave. Inicia entrenamiento tipo Square Wave Endurance Exercise Test combinado con ventilación dirigida contrastada (Comprehensive Directed Breathing) y oxigenoterapia en el ejercicio. Tras 40 sesiones de 90min se analizan parámetros físicos (frecuencia cardiaca, respiratoria y SaO2) en reposo y tras el ejercicio, funcionales (disnea de reposo y esfuerzo) y espirométricos. Resultados: Tras 8 semanas de entrenamiento se objetivan mejoras en la frecuencia cardiorrespiratoria, la SaO2, la disnea de reposo y esfuerzo, la gasometría y la espirometría (PEF 4,8L/s [+98%] y PIF 3,9L/s [+48%]), manteniéndose a los 6 meses, uno y 3 años. Conclusión: El tratamiento combinado comprehensive directed breathing -Square Wave Endurance Exercise Test con oxigenoterapia durante el ejercicio supervisado mejora la frecuencia cardiorrespiratoria, la SaO2, la disnea, la gasometría y la espirometría, manteniéndose a los 6 meses, uno y 3 años
Objective: To evaluate the effect of combined treatment with comprehensive directed breathing and Square Wave Endurance Exercise Test in cycle ergometer associated with oxygen therapy on exercise in a patient with severe COPD, chronic respiratory failure and cardiopulmonary exacerbation. Methods: Treatment with Square Wave Endurance Exercise Test, comprehensive directed breathing, and oxygen therapy during exercise was implemented in a 61-year-old patient with severe COPD. After 40 sessions of 90min, an analysis was performed on the physical parameters, including heart and respiratory rate, oxygen saturation, gasometry, and spirometry. Results: After 8 weeks of training, improvement were obtained in heart and respiratory rates, oxygen saturation, dyspnoea, gasometry, and spirometry (PEF 4.8L/s [+98%] and PIF 3.9L/s [+48%]) at 6 month and one and 3 years. Conclusion: Comprehensive directed breathing -Square Wave Endurance Exercise Test and oxygen therapy during exercise improved clinical and functional parameters at 6 months, and one and 3 years
Subject(s)
Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Respiratory Insufficiency/rehabilitation , Breathing Exercises/methods , Acute Disease/rehabilitation , Treatment Outcome , Oxygen Inhalation Therapy , Physical Therapy ModalitiesABSTRACT
The concept of assisted ventilation in the home setting has greatly progressed as a routine practice. This technique was used from 1990 to 2000 in 16 children cared for at our center. Ten children had neuromuscular disease (infantile spinal amyotrophy 6, Duchenne myopathy 3, and mitochondrial myopathy 1) or other conditions including central hypoventilation (n = 2), traumatic tetraplegia (n = 2), encephalopathy with chronic bronchitis (n = 1) and bronchopulmonary dysplasia (n = 1). Only 5 children had a tracheotomy, the others were treated successfully with non-invasive ventilatory assistance. Initialization of non-invasive ventilatory assistance had been planned before development of respiratory failure in 4 of the 11 children, but generally was indicated after an episode of acute respiratory distress. Home ventilation, particularly with non-invasive assistance is a reliable method for long-term treatment of chronic alveolar hypoventilation in children. The appropriate time for initiating this therapy should be better defined.
