The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

AUGMENTED VENTILATION TO IMPROVE ACTIVITIES OF DAILY LIVING-A CASE STUDY.

Kimberly S. Wiles1, Robert McCoy3, Toni Brennan1, Brian Carlin2; 1Klingensmith HealthCare, Ford City, PA; 2Drexel University, Pittsburgh, PA; 3Valley Inspired Products, Apple Valley, MN

Introduction: Respiratory insufficiency is a limiting factor for patients with chronic lung disease when performing activities of daily living (ADL). Contributing factors include hypoventilation, perfusion and poor conditioning, thus preventing patients from exercising or performing ADLs. It has been showed that supplying non-invasive ventilation and oxygen during walking could offset some of the functional impairment associated with advanced COPD. A new non-invasive open ventilation system (NIOV™, Breathe Technologies, Irvine, CA), is a 1lb device that can be easily carried and provides both oxygen therapy and ventilation. As part of a pilot study, we evaluated a 79 year old male with Stage IV COPD while performing ADL activities and exercise using his oxygen system followed by the same activities using the NIOV™ system. The severity of his disease has limited the patient’s ability to go outside of his home without severe dyspnea, fatigue and fear. The patient was evaluated at home and asked to establish a motivational goal. Baseline information was collected on the patient’s status using his current oxygen as well as the NIOV™ system. SpO2, HR, and RR were collected along with Borg, Comfort rating system (CRS) and Fatigue rating systems (FRS) at the beginning, middle and end of the ADL exercise. The same information and activities were recorded after using the NIOV™device for 46 days. After 46 days, ADL activity and exercise remained limited on the patient’s oxygen system, but showed improvement on the NIOV™. While using the NIOV™ and performing ADLs and exercise the SpO2 was 3% higher with lower respiratory rates, Borg, CRS and FRS scores. His exercise on the treadmill increased from 8 minutes to 16 minutes. The patient’s daily routine now includes a minimum of 15 minutes of exercise with either a stationary bicycle or treadmill. Prior to using the NIOV™, he was unable to exercise and never left his home. Since using the NIOV™, he has been able to resume an active lifestyle and achieve his goal of driving his car and taking walks. Conclusion: Ambulatory augmented ventilation in the home enabled this patient to go from a sedentary lifestyle to an active one. Clinical implications for the therapy are to enable participation in pulmonary rehabilitation as well as resuming ADLs. With the overall improvement in conditioning, SpO2/RR and dyspnea the patient’s risk of complications should be diminished. Sponsored Research - None