Noninvasive ventilation and pulmonary rehabilitation

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with progressive airflow obstruction that leads to considerable disability; these patients have reduced exercise capacity, associated with mood disturbance and impaired quality of life. For most patients with COPD, training programmes alone are sufficient to achieve improvements in exercise tolerance. However, for patients further compromised by ventilatory limitation, the use of noninvasive positive pressure ventilation (NPPV) with physical training or domiciliary ventilatory support during an outpatient rehabilitation programme may augment benefits. The use of NPPV with exercise has been shown to increase exercise tolerance, reduce dyspnoea and unload the respiratory muscles. Domiciliary NPPV during a rehabilitation programme may also improve exercise capacity and health status and requires further evaluation in longer term studies.