[Effect of a 2-year pulmonary rehabilitation on the 7-year prognosis in patients with advanced chronic obstructive pulmonary disease]. / Wplyw 2-letniej rehabilitacji oddechowej na 7-letnie rokowanie u chorych z zaawansowana przewlekla obturacyjna choroba pluc.

Pulmonary rehabilitation (PR) improve the quality of life in COPD patients, however, little has been known whether it may improve the survival. We assessed 7-year prognosis in 46 patients with advanced COPD, 27 of which completed successfully 2-year course of PR whereas 19 COPD patients made a control (C) group. At the end of 7-year observation 41.3% of total number of patients survived, among them 12 (42.8%) PR patients and 7 (38%) C patients. COPD progression was the main (80%) reason of mortality in both groups. The survivors had better results of baseline FVC, FEV1 and treadmill exercise test. They did not differ from non-survivors with age, baseline results of the weight, PaO2, PaCO2 and the number of PR patients. The Cox proportional hazard analysis showed that neither of baseline parameters influenced significantly the 7-year prognosis in this group of COPD patients. In conclusion, PR failed to improve 7-year prognosis in the studied group of patients with advanced COPD.

[Oxygen saturation at rest, on exercise and during sleep in COPD patients undergoing pulmonary rehabilitation program. Two years prospective controlled study]. / Kontrolowane badanie przezskórne wysycenia tlenem krwi tetniczej w czasie dnia, w nocy oraz w czasie wysilku u rehabilitowanych chorych na POChP.

The role of pulmonary rehabilitation (PR) in COPD patients is well established. However, the PR programs includes physical exercise that may deteriorate chronic hypoxemia. The objective of the study was to evaluate impact of a long term PR program on oxygen saturation at rest, on exercise and during sleep in COPD patients no receiving supplemental oxygenation. A two--year controlled study involved 27 rehabilitated (PR-COPD patients (6 females) aged 32-76 years, mean 58.1 years on average and 19 control (C-COPD patients (3 females) aged 58-83 years, mean 68. COPD patients participating in PR program patients were younger, had higher value of FVC and FEV1 and better results of METs during symptom-limited exercise test (ET, p = 0.007). They also had better results of transcutaneus oxygen saturation (SaO2) at rest (p = 0.02), a lower maximal decrease in SaO2 during ET(p = 0.003) and a higher value of medan SaO2 during (p = 0.02). Following PR program the number of METs achieved during ET increased in PR-COPD patients (p = 0.007) and did not change in C-COPD, p = NS. The SaO2 at rest did not change significantly in both groups. Maximal drop in SaO2 during ET decreased in PR-COPD patients (p = 0.02) and did not change in C-COPD(p = NS) group. Median SaO2 at sleep did not change in PR-COPD patients (p = NS) but it decreased in C-COPD patients (p = 0.02). The study indicates that long term PR does not deteriorate the resting diurnal hypoxaemia, it prevent COPD patients from time depending exacerbation of nocturnal hypoxaemia and can improve oxygen saturation on exertion. The results could be influenced by baseline differences between PR-COPD and C-COPD patients.