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Continuous positive airway pressure acutely increases exercise duration in children with severe therapy-resistant asthma: a randomized crossover trial

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Abstract

Background

Lower exercise tolerance is an important component of asthma and the possible effects of non-invasive ventilation on exercise capacity in individuals with severe therapy-resistant asthma (STRA) are unknown. This study aimed to evaluate the immediate effect of continuous positive airway pressure (CPAP) on exercise tolerance in children with STRA.

Methods

We performed a controlled, randomized, crossover clinical trial including subjects aged 6 to 18 years old diagnosed with STRA. Clinical, anthropometric and lung function data were collected. The participants in the intervention group (IG) used CPAP (PEEP 10cmH2O and FiO2 0.21) for a period of 40 min. Subjects in the control group (CG) used CPAP with minimum PEEP at 1 cmH20 also for 40 min. Afterwards, subjects from both groups underwent cardiopulmonary exercise testing (CPET). After a 15-day washout period, on a subsequent visit, subjects participated in the opposite group to the initial one.

Results

Thirteen subjects with a mean age of 12.30 ± 1.7 years were included. The variables of peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1) before using CPAP and after performing CPET did not show significant differences. Regarding CPET results, there was no significant difference (P = 0.59) between groups at peak exercise for oxygen consumption—VO2 (CG: 33.4 ± 6.3 and IG: 34.5 ± 5.9, mL kg−1 min−1). However, the IG (12.4 ± 2.1) presented a total test time (min) significantly (P = 0.01) longer than the CG (11.5 ± 1.3).

Conclusion

The results suggest that the use of CPAP before physical exercise increases exercise duration in children and adolescents with STRA.

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Funding

This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) – finance code 001—and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

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Authors and Affiliations

  1. Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6690, 2º andar, Porto Alegre, RS, CEP 90610-000, Brazil

    Cláudia Silva Schindel, Daniele Schiwe, João Paulo Heinzmann-Filho, Natália Evangelista Campos & Márcio Vinícius Fagundes Donadio

  2. Hospital Moinhos de Vento, Porto Alegre, Brazil and Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil

    Paulo Márcio Pitrez

Authors
  1. Cláudia Silva Schindel
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  2. Daniele Schiwe
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  3. João Paulo Heinzmann-Filho
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  4. Natália Evangelista Campos
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  5. Paulo Márcio Pitrez
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  6. Márcio Vinícius Fagundes Donadio
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Contributions

MD had substantial contributions to the study including Conceptualization, Data curation, Formal analysis, Project administration, Resources, Supervision, Writing—review & editing. CS had substantial contributions to the study including Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing—original draft. DS, NC, JHF, and PP had substantial contributions to the study including Data curation, Investigation, Methodology, Writing—review & editing.

Corresponding author

Correspondence to Márcio Vinícius Fagundes Donadio.

Ethics declarations

Ethical approval

The study was approved by the University research ethics committee (CEP-PUCRS) with number 48678115.9.0000.5336. All guardians signed an informed consent form, and children and adolescents aged ≥ 8 years signed an assent form.

Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Clinical Trial register number

NCT03215303.

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Schindel, C.S., Schiwe, D., Heinzmann-Filho, J.P. et al. Continuous positive airway pressure acutely increases exercise duration in children with severe therapy-resistant asthma: a randomized crossover trial. World J Pediatr 17, 189–196 (2021). https://doi.org/10.1007/s12519-021-00425-0

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  • DOI: https://doi.org/10.1007/s12519-021-00425-0

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