CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Effect of oxygen on recovery from maximal exercise in patients with chronic obstructive pulmonary disease

N J Stevenson, P M A Calverley

Clinical Science Centre, University Hospital Aintree, Liverpool L9 7AL, UK

Correspondence to:
Correspondence to:
Professor P M A Calverley
Clinical Science Centre, University Hospital Aintree, Liverpool L9 7AL, UK; pmacal{at}liverpool.ac.uk

Background: The effects of oxygen on recovery from exercise in patients with chronic obstructive pulmonary disease (COPD) are not clearly known. A study was undertaken to determine whether oxygen given after maximal exercise reduced the degree of dynamic hyperinflation and so reduced the perception of breathlessness.

Methods: Eighteen patients with moderate to severe COPD performed maximal symptom limited exercise on a cycle ergometer. During recovery they received either air or oxygen at identical flow rates in a randomised, single blind, crossover design. Inspiratory capacity, breathing pattern data, dyspnoea intensity, and leg fatigue scores were collected at regular intervals during recovery. At a subsequent visit patients underwent a similar protocol but with a face mask in situ to eliminate the effects of instrumentation.

Results: When oxygen was given the time taken for resolution of dynamic hyperinflation was significantly shorter (mean difference between air and oxygen 6.61(1.65) minutes (95% CI 3.13 to 10.09), p = 0.001). Oxygen did not, however, reduce the perception of breathlessness during recovery nor did it affect the time taken to return to baseline dyspnoea scores in either the instrumented or non-instrumented state (mean difference 2.11 (1.41) minutes (95% CI –0.88 to 5.10), p = 0.15).

Conclusions: Oxygen reduces the degree of dynamic hyperinflation during recovery from exercise but does not make patients feel less breathless than breathing air. This suggests that factors other than lung mechanics may be important during recovery from exercise, or it may reflect the cooling effect of both air and oxygen.

Abbreviations: FEV₁, forced expiratory volume in 1 second; FRC, functional residual capacity; FVC, forced vital capacity; IC, inspiratory capacity; MIP, maximal inspiratory capacity; MEP, maximal expiratory capacity; NEP, negative expiratory pressure; TFL, tidal expiratory flow limitation; TLC, total lung capacity; VE, minute ventilation; VO₂max, maximal oxygen consumption; VCO₂max, maximal carbon dioxide production; VT, tidal volume

Keywords: oxygen; breathlessness; dynamic hyperinflation; exercise; chronic obstructive pulmonary disease

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