Long-term non-invasive mechanical ventilation improves six minutes walk distance in patients with chronic respiratory failure*
More details
Hide details
İntensive Care Unit, Sureyyapasa Chest Medicine and Thoracic Surgery Teaching Hospital, Istanbul, Turkey
Cardiology Department, Istınye State Hospital, Istanbul, Turkey
Department of Pulmonary Medicine, School of Medicine, Istanbul Bilim University, Istanbul, Turkey
Department of Pulmonary Medicine, Fulya Acıbadem Hospital, Istanbul, Turkey
Corresponding author
Levent Dalar   

Dept. of Pulmonary Medicine, School of Medicine, Istanbul Bilim University Sisli Florence Nightingale Hospital Abidei Hurriyet cad. No: 164 Sisli, Istanbul, 34370, Turkey
Pneumon 2014;27(3):220-225
*This study was presented at the Turkish Thoracic Society 13th Annual Congress.

To investigate the effect of long-term non-invasive mechanical ventilation (LTMV) on exercise performance measured by the 6-minute walk test (6MWT) in patients with chronic respiratory failure (CRF).

Materials and Method:
A prospective study was conducted in a tertiary referral hospital between January 2007 and April 2008 on 21 consecutive patients with a diagnosis of CRF and indications for non-invasive mechanical ventilation (NIV) at home. The patients were evaluated using the 6MWT on two occasions; before the LTMV therapy and in the 6th month of therapy. Dyspnoea and fatigue were evaluated by a modified Borg scale at the beginning and at the end of the 6MWT. Other factors evaluated included the type of NIV device, inspiratory and expiratory pressures, arterial blood gasses (ABG), pulmonary function tests (PFT) and the findings on transthoracic echocardiography (TTE).

Of the 21 patients, 14 were male, 14 (66.7% had chronic obstructive pulmonary disease (COPD), 2 (9.5%) had kyphoscoliosis, 2 (9.5%) had obstructive sleep apnoea syndrome (OSAS), 2 (9.5%) had tuberculosis sequelae, and one (4.8%) had obesity hypoventilation syndrome (OHS). The mean 6MWT distance was found to have increased from 237.71 m to 295.14 m with the use of LTMV for 6 months. Improvement was detected in the mean PaO2/FiO2 ratio, from 259 mmHg to 269.57 mmHg. No change was observed in the resting dyspnoea scores and fatigue scores with the use of LTMV at the beginning of 6MWT, but the dyspnoea scores at the end of 6MWT showed significant improvement with treatment. Blood gas analysis after LTMV use revealed no change in pH values, SaO2 % or PaO2/FiO2 ratio. A borderline significant decrease was found in PaCO2 (p= 0.057). Among PFT values, statistically significant increase was observed only in forced expiratory volume in one second (FEV1).

LTMV use in patients with CRF results in significant improvement in exercise capacity. 6MWT can be a useful tool for the objective evaluation of functional exercise capacity in patients with CRF.

The authors have no conflict of interest.
Leger P, Bedicam JM, Cornette A, et al. Nasal intermittent positive pressure ventilation: Long-term follow-p in patients with severe chronic respiratory insufficiency. Chest 1994; 105:100-5.
Tsolaki V, Pastaka C, Karetsi E, et al. One-year non-invasive ventilation in chronic hyperkapnic COPD: Effect on quality of life. Respiratory Meedicine 2008; 102:904-11.
Modell JH, Graves SA, Ketover A. Clinical course of 91 consecutive near-drowning victims. Chest 1976; 70:231-8.
American Thoracic Society. Standardization of spirometry. 1987 update. Statement of the American Thoracic Society. Am Rev Respir Dis 1987; 136:1285-98.
Casaburi R, Coates AL, Enright PL, et al. ATS Statement: Guidelines for the Six-Minute Walk Test. American Journal of Respiratory and Critical Care Medicine. 2002; 166:111-7.
Fox EL, Bowers RW, Foss ML. The physiological basis of physical education and athletics. Dubuque: Wm C Brown Publishers 1989; 435.
Pinto-Plata VM, Cote C, Cabral H, Taylor J, Celli BR. The 6-min walk distance: change over time and value as a predictor of survival in severe COPD. Eur Respir J 2004; 23:28-33.
Szekely LA, Oelberg DA, Wright C, et al. Preoperative predictors of operative morbidity and mortality in COPD patients undergoing bilateral lung volume reduction surgery. Chest 1997; 111:550-8.
CoteCG, CasanovaC, MarinJM, et al. Validation and comparison of reference equations for the 6-min walk distance test. Eur Respir J 2008; 31:571-8.
Casanova C, Cote CG, Marin JM, et al. The 6-min walking distance: long-term follow up in patients with COPD Eur Respir J 2007; 29:535-40.
Carter R, Holiday DB, Nwasubura C, Stocks J, Grouthues C, Tiep B. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest 2003; 123:1408-15.
Wijkstra PPJ, Lacasse Y, Guyatt GH, Goldstein R, Struik F. Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease. Cochrane Library 2009, Issue 3.
Morante F, Güell R, Mayos M. Efficacy of the 6-Minute Walk Test in Evaluating Ambulatory Oxygen Therapy. Archivos de Bronconeumologia 2005; 41:596-600.
Morrison D, Skwarski KM, MacNee W. The adequacy of oxygenation in patients with hypoxic chronic obstructive pulmonary disease treated with long-term domiciliary oxygen. Respir Med 1997; 91:287-91.
Pilling J, Cutaia M. Ambulatory oximetry monitoring in patients with severe COPD: a preliminary study. Chest1999; 116:314-21.
Journals System - logo
Scroll to top