The Effect of Helium and Oxygen on Exercise Performance in Chronic Obstructive Pulmonary Disease: A Randomized Crossover Trial

Breathing supplemental oxygen reduces breathlessness during exercise in patients with chronic obstructive pulmonary disease (COPD). Replacing nitrogen with helium reduces expiratory flow resistance and may improve lung emptying. Combining these treatments should be independently effective. Study the...

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Bibliographic Details
Published in:	American journal of respiratory and critical care medicine Vol. 173; no. 8; pp. 865 - 870
Main Authors:	Laude, Elizabeth A, Duffy, Nicholas C, Baveystock, Chloe, Dougill, Beatriz, Campbell, Michael J, Lawson, Rod, Jones, Paul W, Calverley, Peter M
Format:	Journal Article
Language:	English
Published:	New York, NY Am Thoracic Soc 15-04-2006 American Lung Association American Thoracic Society
Subjects:	Aged Aged, 80 and over Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease, asthma Cross-Over Studies Diseases of the respiratory system Dyspnea Exercise Tolerance - physiology Female Follow-Up Studies Forced Expiratory Volume - physiology Gases Heart rate Helium Helium - therapeutic use Humans Intensive care medicine Male Medical sciences Middle Aged Nitrogen Oxygen Inhalation Therapy - methods Pneumology Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Disease, Chronic Obstructive - therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Spirometry Treatment Outcome Walking Walking - physiology United Kingdom > UK Physical exercise Lung disease Oxygen Intensive care Respiratory disease Chronic disease Helium exercise capacity Bronchus disease Oxygen effect Obstructive pulmonary disease Resuscitation chronic obstructive pulmonary disease
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Summary:	Breathing supplemental oxygen reduces breathlessness during exercise in patients with chronic obstructive pulmonary disease (COPD). Replacing nitrogen with helium reduces expiratory flow resistance and may improve lung emptying. Combining these treatments should be independently effective. Study the effect of changing oxygen or helium concentration in inspired gas during exercise in patients with stable COPD. In 82 patients (mean age, 69.7 yr; mean FEV(1), 42.6% predicted), we measured endurance shuttle walking distance, resting and exercise oxygen saturation, and end-exercise dyspnea (Borg scale) while patients breathed Heliox28 (72% He/28% O(2)), Heliox21 (79% He/21% O(2)), Oxygen28 (72% N(2)/28% O(2)), or medical air (79% N(2)/21% O(2)). Gases were administered using a randomized, blinded, crossover design via a face mask and an inspiratory demand valve. Breathing Heliox28 increased walking distance (mean+/-SD, 147+/-150 m) and reduced Borg score (-1.28+/-1.30) more than any other gas mixture. Heliox21 significantly increased walking distance (99+/-101 m) and reduced dyspnea (Borg score, -0.76+/-0.77) compared with medical air. These changes were similar to those breathing Oxygen28. The effects of helium and oxygen in Heliox28 were independent. The increase in walking distance while breathing Heliox28 was inversely related to baseline FEV(1) breathing air. Reducing inspired gas density can improve exercise performance in COPD as much as increasing inspired oxygen. These effects can be combined as Heliox28 and are most evident in patients with more severe airflow obstruction.
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ISSN:	1073-449X 1535-4970
DOI:	10.1164/rccm.200506-925OC