LUNG VENTILATION FUNCTION AND PULMONARY GAS EXCHANGE IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE DURING COMBINED APPLICATION OF HYPOXIC TRAINING AND RESPIRATORY TRAINING WITH POSITIVE END-EXPIRATORY PRESSURE

Abstract

Introduction. Treatment of chronic obstructive pulmonary disease (COPD) in elderly patients is often limited, leading to inadequate disease control. To enhance treatment effectiveness in elderly individuals with COPD, attention has been drawn to non-pharmacological methods, including hypoxic training and respiratory training with positive end-expiratory pressure (PEEP). Aim. To assess the duration and effectiveness of combined application of hypoxic training and respiratory training with PEEP on lung ventilation function and pulmonary gas exchange in elderly patients with COPD. Materials and methods. Forty-six elderly patients with COPD were examined: a group (15 individuals) with the application of respiratory training with PEEP, a group (15 individuals) with the application of hypoxic training, and a group (16 individuals) with the application of respiratory training with PEEP and hypoxic training. Before training, immediately after the training course, one month, and three months after the course of hypoxic and/or respiratory training with PEEP, lung ventilation function, bronchial patency, and blood saturation were determined. Results. The application of hypoxic training and/or respiratory training with PEEP in elderly patients with COPD led to increased speed parameters reflecting bronchial patency. Also, after the course of hypoxic and/or respiratory training with PEEP, the FVC parameter increased in the examined patients, mainly due to ERV. Hypoxic training, compared to respiratory training with PEEP, had slight advantages in its effect on lung ventilation function in elderly patients with COPD. Application of INGT and/or breathing training with PEER resulted in an increase in SpO2. The combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD led to increased effectiveness and duration of therapeutic effect. The impact on bronchial patency and SpO2 of respiratory training with PEEP and/or hypoxic training was greater in patients with pronounced disease symptoms. Conclusions. Separate application of respiratory training with PEEP or hypoxic training contributes to increased ventilation, decreased bronchial obstruction and increasing blood saturation, but the therapeutic effect is short-term and lasts no longer than a month. Meanwhile, the combined application of hypoxic training and respiratory training with PEEP in elderly patients with COPD leads to more significant improvement in ventilation and bronchial patency. At the same time, the duration of the therapeutic effect persists for three months. The effectiveness of respiratory training with PEEP and/or hypoxic training in elderly patients with COPD depends on the clinical symptoms of the disease: the more pronounced the symptoms, the greater the impact.