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Open AccessJournal ArticleDOI

Heliox, dyspnoea and exercise in COPD

TLDR
There was high level of evidence with a low risk of bias supporting Heliox's effectiveness in improving the intensity and endurance of exercise when compared to room air for people with COPD and little conclusive evidence was found to determine whether Heliox altered the sensation of dyspnoea during exercise.
Abstract
One of the most important determinants of physical and mental well-being of people with chronic obstructive pulmonary disease (COPD) is participation in physical activity. The ability to alter the sensation of dyspnoea during exercise may improve both exercise duration and intensity. Despite the low density, inert nature, strong safety profile and multiple applications of helium gas, the potential benefit of helium-oxygen gas mixtures as an adjunct therapy to modify disease symptoms and exercise capabilities in obstructive lung diseases has only recently been explored. This is a systematic review of the available peer-reviewed evidence exploring whether symptom modification (perceived levels of dyspnoea) and exercise performance in COPD (either intensity or duration of work) are modified by inhalation of Heliox. Eight experimental studies met inclusion for this review. A variety of methodologies and outcome variables were used negating meta-analysis and hampering direct comparison between interventions. Overall, there was high level of evidence with a low risk of bias supporting Heliox's effectiveness in improving the intensity and endurance of exercise when compared to room air for people with COPD. Little conclusive evidence was found to determine whether Heliox altered the sensation of dyspnoea during exercise.

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Pathogenesis of hyperinflation in chronic obstructive pulmonary disease.

TL;DR: The aim of this review is to address the more recent literature regarding the pathogenesis, assessment, and management of both static and dynamic lung hyperinflation in patients with COPD.
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Lung hyperinflation in chronic obstructive pulmonary disease: mechanisms, clinical implications and treatment

TL;DR: The contribution of lung hyperinflation to exercise limitation and its impact on symptoms and physical activity are outlined and the physiological rationale and efficacy of selected pharmacological and non-pharmacological ‘lung deflating’ interventions aimed at improving Symptoms and physical functioning are examined.
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TL;DR: A case of COPD in an 81-year-old man hospitalized with severe dyspnea and respiratory failure highlights both the challenges in managing COPd in the elderly and the limitations in applying guidelines to geriatric patients.
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Exercise and its impact on dyspnea.

TL;DR: In this review, the current mechanistic model of exertional dyspnea is summarized and new research demonstrating how treatment strategies improve Dyspnea by reducing central ventilatory drive, improving dynamic Ventilatory mechanics, and improving respiratory muscle function is highlighted.
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Physiologic Effects of an Ambulatory Ventilation System in Chronic Obstructive Pulmonary Disease

TL;DR: NIOV+O₂ yielded substantial exercise endurance improvements accompanied by respiratory muscle unloading and dyspnea reductions in patients with severe hypoxemic COPD.
References
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Book

Chronic obstructive pulmonary disease

TL;DR: The most important bacterial causes of exacerbations of COPD are nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Chlamydia pneumoniae.
Journal ArticleDOI

Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2007 update.

TL;DR: Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; and an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies.
Journal ArticleDOI

Hyperinflation, Dyspnea, and Exercise Intolerance in Chronic Obstructive Pulmonary Disease

TL;DR: Long-acting bronchodilators have recently been shown to reduce hyperinflation during both rest and exercise in moderate to severe COPD, which allows greater Vt expansion for a given inspiratory effort during exercise with consequent improvement in dyspnea and exercise endurance.
Journal ArticleDOI

Pathophysiology of dyspnea in chronic obstructive pulmonary disease: a roundtable.

TL;DR: A review of the neurophysiology of dyspnea in chronic obstructive pulmonary disease (COPD) can be found in this paper, with the aim of applying this knowledge to the clinical setting.
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