Noninvasive ventilatory assistance during exercise for patients with kyphoscoliosis -: A pilot study

The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cm H20) plus positive end expiratory pressure (PEEP) (4 cm H20) via a nasal mask. Of the compared parameters., heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 vs. 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 vs. 69.5 +/- 15.7 mm Hg), and hypercapnia (PaCO2 = 54.3 +/- 7.6 vs. 47.1 +/- 7.1 mm Hg) were significantly greater for the SBT than for the NIVT (P < 0.05). The hypercapnia and hypoxia for the NIVT were not significantly greater than preexercise resting levels. Dyspnea and perceived effort were significantly greater for the SBT (P < 0.05). In conclusion, NIV can improve clinical and physiologic response to exercise.