Erratum to: Influence of respiratory pressure support on hemodynamics and exercise tolerance in patients with COPD

Inspiratory pressure support (IPS) plus positive end-expiratory pressure (PEEP) ventilation might potentially interfere with the “central” hemodynamic adjustments to exercise in patients with chronic obstructive pulmonary disease (COPD). Twenty-one non- or mildly-hypoxemic males (FEV 1 = 40.1 ± 10.7% predicted) were randomly assigned to IPS (16 cmH 2 O) + PEEP (5 cmH 2 O) or spontaneous ventilation during constant-work rate (70–80% peak) exercise tests to the limit of tolerance ( T lim ). Heart rate (HR), stroke volume (SV), and cardiac output (CO) were monitored by transthoracic cardioimpedance (Physioflow™, Manatec, France). Oxyhemoglobin saturation was assessed by pulse oximetry (SpO 2 ). At similar SpO 2 , IPS 16 + PEEP 5 was associated with heterogeneous cardiovascular effects compared with the control trial. Therefore, 11 patients (Group A) showed stable or increased Δ “isotime” – rest SV [5 (0–29) mL], lower ΔHR but similar ΔCO. On the other hand, ΔSV [−10 (−15 to −3) mL] and ΔHR were both lower with IPS 16 + PEEP 5 in Group B ( N = 10), thereby reducing ΔCO ( p < 0.05). Group B showed higher resting lung volumes, and T lim improved with IPS 16 + PEEP 5 only in Group A [51 (−60 to 486) vs. 115 (−210 to 909) s, respectively; p < 0.05]. We conclude that IPS 16 + PEEP 5 may improve SV and exercise tolerance in selected patients with advanced COPD. Impaired SV and CO responses, associated with a lack of enhancement in exercise capacity, were found in a sub-group of patients who were particularly hyperinflated at rest.