Effects of breath training pattern “end-lnspiratory pause” on respiratory mechanics and arterial blood gas of patients with COPD

Yong-jie Liang1, Ying-yun Cai2
1Pulmonary Department, Eastern Hospital, Shanghai
2Pulmonary Department, Zhongshan Hospital, Fudan University

Tóm tắt

In order to explore the mechanism of Chinese traditional breath training, the effects of end-inspiratory pause breathing (EIPB) on the respiratory mechanics and arterial blood gas were studied in patients with chronic obstructive pulmonary disease (COPD). Ten patients in steady stage participating in the study had a breath training of regulating the respiration rhythm as to having a pause between the deep and slow inspiration and the slow expiration. Effect of the training was observed by visual feedback from the screen of the respiratory inductive plethysmograph. The dynamic change of partial pressure of oxygen saturation in blood (SpO2) was recorded with sphygmo-oximeter, the pulmonary mechanics and EIPB were determined with spirometer, and the data of arterial blood gases in tranquilized breathing and EIPB were analysed. After EIPB training, SpO2 increased progressively, PaO2 increased and PaCO2 decreased, and the PaO2 increment was greater than the PaCO2 decrement. Furthermore, the tidal volume increased and the frequency of respiration decreased significantly, both inspiration time and expiration time were prolonged. There was no significant change in both mean inspiration flow rate (VT/Ti) and expiration flow rate (VT/Te) . The baselines in spirogram during EIPB training had no raise. EIPB could decrease the ratio of the dead space and tidal volume (VD/VT), cause increase of PaO2 more than the decrease of PaCO2, suggesting that this training could improve both the function of ventilation and gaseous exchange in the lung. EIPB training might be a breathing training pattern for rehabilitation of patients with COPD.

Tài liệu tham khảo

Liang YJ, Cai YY, Wang ZX. The effects of Chinese traditional breathing training on the exercise test, resistance breathing and quality of life in COPD patients. Chin Med J 1998; 111(4): 318. Bai CX, Niu SF, Cai YY. A study of Qigong rehabilitation on patients with chronic obstructive pulmonary. Chin J Rehab 1992;7(4): 167–170. Respiratory Disease division, Chinese Medical Association. Guideline of diagnosis and treatment about COPD (a draft). Chin J Tuberc & Respir Dis 1997; 20(4): 199 -203. Duanti R, Misuri G, Gorini M. Mechanical loading and control of breathing in patients with severe chronic obstructive pulmonary disease. Thorax 1995; 50(2): 127–133. Rochester DF. Respiratory muscles and ventilatory failure: 1993 perspective. Am J Med Sci 1993; 305(6): 394–402. Begin P and Grassino A. Inspiratory muscle dysfunction and chronic hypercapnia in chronic obstructive pulmonary disease. Am Rev Respir Dis 1991; 143(5): 905–912. Kollef MH, Turner JF. Intrinsic PEEP and unilateral lung hyperinflation. Chest 1992; 102(4): 1220–1224. Ninane V, Yernault JC, de Troyer A. Intrinsic PEEP in patients with chronic obstructive pulmonary disease: role of expiratory muscle. Am Rev Respir Dis 1993 ; 148(4): 1037–1042.