Acute Effects of Oxygen Supplementation on Quadriceps Neuromuscular Fatigue in Patients With COPD and Chronic Respiratory Failure.

IF 9.8 1区医学 Q1 CRITICAL CARE MEDICINE

Chest Pub Date : 2026-07-24 DOI:10.1016/j.chest.2026.07.5206

Mara Paneroni, Michele Vitacca, Carla Simonelli, Laura Spinello, Armando Coccia, Federica Amitrano, Giovanni D'Addio, Beatrice Salvi, Massimo Venturelli

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Abstract

Background: Patients with COPD and chronic respiratory failure (CRF) receiving long-term oxygen therapy experience exaggerated quadriceps neuromuscular fatigue (NMF). In this context, the effect of oxygen therapy on NMF remains unclear.

Research question: What is the impact of different Fio₂ levels on neuromuscular fatigue during intermittent isometric quadriceps exercise in a population with COPD and CRF?

Study design and methods: Three intermittent isometric quadriceps tests, all at 80% of the time to exhaustion (TTE) at 30% of maximal voluntary contraction (MVC), were performed randomly in each patient with 3 different Fio₂ measurements: 21%, 30%, and 60%. TTE was evaluated previously by breathing Fio₂ at 21%. NMF was assessed through changes in MVC, twitch force quadriceps potentiated (Qtwpot), and voluntary activation (VA) after exercise (at peak, and at 30 seconds and 10 minutes after). Electromyography results were evaluated continuously.

Results: We enrolled 20 patients (80.9% male; mean [SD] age, 71.80 [5.81] years; mean [SD] FEV₁ to FVC ratio, 39.56 [9.32]; mean [SD] residual volume, 206.49% [53.14%]). Mean (SD) MVC changes were -27.60% (9.50%), -24.35% (7.80%), and -22.00% (7.13%) for the 21%, 30%, and 60% tests, respectively (P = .0341), with differences between the 21% and 30% Fio₂ measurements (P = .032) and 21% and 60% tests (P = .032). Qtwpot showed mean (SD) changes of -31.10% (14.30%), -31.25% (16.70%), and -26.70% (16.10%) for the 21%, 30%, and 60% tests, respectively (P = .019), with differences between the 21% and 60% tests (P = .027) and the 30% and 60% tests (P = .014). VA decreased similarly across conditions (P = .211).

Interpretation: Our results show that acute oxygen administration reduces quadriceps NMF in patients with COPD and CRF. These results highlight the role of oxygen availability in modulating NMF in this population. Future studies should investigate this effect during exercise training, as well as long-term consequences.

Clinical trial registration: ClinicalTrials.gov; No.: NCT05533957; URL: www.

Clinicaltrials: gov.

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补充氧气对慢性呼吸衰竭患者股四头肌神经肌肉疲劳的急性影响。

背景：慢性阻塞性肺疾病（COPD）和慢性呼吸衰竭（CRF）患者在长期氧疗（LTOT）下会出现严重的股四头肌神经肌肉疲劳（NMF）。在这种情况下，氧疗对NMF的影响尚不清楚。研究问题：COPD-CRF人群间歇等长四头肌运动时，不同FiO2水平对神经肌肉疲劳的影响是什么？研究设计和方法：每个患者在三种不同的FiO2 (F)下随机进行三项间歇等长股四头肌试验(t)，所有试验均在最大自愿收缩（MVC）的30%至疲劳时间（TTE）的80%时进行：T-F21为21%，T-F30为30%，T-F60为60%。TTE先前通过呼吸FiO2为21%来评估。NMF通过运动后（高峰、30 ‘和10’后）MVC、股四头肌肌力增强（Qtwpot）和自愿激活（VA）的变化来评估。持续评估肌电图。结果：20例患者入组，男性80.9%,71.80±5.81岁，FEV1/FVC 39.56±9.32,RV 206.49±53.14%。T-F21、T-F30、T-F60的MVC变化分别为-27.60±9.50%、-24.35±7.80%、-22.00±7.13% (P = 0.0341)，其中T-F21与T-F30、T-F21与T-F60的差异有统计学意义（P = 0.032）。ΔQtwpot对T-F21、T-F30、T-F60的差异分别为-31.10±14.30%、-31.25±16.70%、-26.70±16.10% (P = 0.019)，其中T-F21与T-F60的差异为（P = 0.027）， T-F30与T-F60的差异为（P = 0.014）。VA在不同条件下也同样下降（P=0.211）。解释：急性给氧可降低COPD合并慢性肾功能衰竭患者的股四头肌NMF。这些结果强调了氧气供应在调节该人群NMF中的作用。未来的研究应该在运动训练期间调查这种影响，以及长期的后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chest 医学-呼吸系统

CiteScore

13.70

自引率

3.10%

发文量

3369

审稿时长

15 days

期刊介绍： At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.