The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

THE CARDIOPULMONARY EFFECT OF HEAT AND MOISTURE EXCHANGE MASK ON COPD PATIENTS DURING COLD EXPOSURE

John Seifert; Health and Human Development, Montana State University, Bozeman, MT

Background It has been well established that cold air inhalation exacerbates cardiopulmonary stress in COPD patients. The frequency of exacerbations increases during the winter which will decrease pulmonary function. As pulmonary function decreases, there is a concomitant decrease in the quality of life because most outdoor activities are eliminated. Thus, minimizing cold air inhalation is an important factor in maintaining functional capacity. A heat and moisture exchange mask (HME) warms and humidifies cold, dry inspired air via latent heat exchange. However, it is not known if COPD patients would benefit from such a mask. The purpose of this study was to investigate the influence of an HME on the cardiopulmonary responses in COPD patients. Methods Following IRB approval, nine COPD patients (stage I: n=6, stage II: n=3) completed 4 intervals of cycling for 5 minutes at 30W followed by 10 minutes seated rest. Subjects completed one trial at 21C (RT) and two trials at -7C. Patients wore an HME or no mask (NM) during cold exposure. Pulmonary function was assessed immediately pre- and 5 min post trial while BP was measured at 15 min intervals during the 60 min exercise. Subjects were dressed in insulated clothing for the cold trials. An ANOVA with repeated measures and paired t-tests were used to analyze data. Alpha level of significance was set at p<.05. Results Percent change from baseline to 60 min was significantly different in the HME (3.3 +4.5%, 5.0+6.8%, 6.2+8.3%) and RT (9.0+11.8%, 8.0+12.5%, 3.4+17.0%) trials compared to the NM trial (-5.3 +5.9%, -7.1+12.0%, -8.9+113.7%) for FVC, FEV1, and FEV.5. % Change for systolic BP was significantly lower at 60 min for HME (3.0+4.0%) and RT (1.5+6.7%) than NM (14.2+6.1%). No differences were observed between HME and RT. One subject was unable to complete the exercise under the NM trial, but was able to complete the 4 intervals during the HME and RT trials. Conclusions Wearing an HME significantly improves cardiopulmonary function in the COPD patient compared to not wearing a mask during cold exposure. Similar results were observed between RT and cold exposure when wearing the HME. Functional capacity can be maintained, similar to that in thermal neutral conditions, when an HME is worn during cold exposure. The evidence suggests that an HME used by COPD patients should be considered as preventative treatment during cold exposure. Sponsored Research - AirGuard Medical Products

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