ABSTRACT

One of the main objectives for GOLD in treatment of COPD patients is to relieve dyspnea. Among other non pharmacologic interventions for improved dyspnea pulmonary rehabilitation (PR), supplementary oxygen, non invasive mechanic ventilation (MVNI), and lung volume reduction surgery (LVRS) are employed. Decreased on dyspnea after a PR program may due because exercise improvement, ventilation decrease, or desensitizing of breathlessness whish cause less dyspnea for the same ventilation. Oxygen supplementary in COPD patients with respiratory failure have shown multiples benefits mainly increasing survival and when failure respiratory is stabilized dyspnea improved too. But only a modest evidence show benefits on dyspnea when patients course with oxygen desaturation during exercise. MVNI in the last years have been used not only during over night but only during the day. Díaz recently shows benefits in improved dyspnea by using the Transitional dyspnea Index. The main objectives for LVRS in severe COPD patients are to improve dyspnea and quality of life. This is possible because hyperinflated areas of emphysema area resecated, then pulmonary volume decreased, and mechanics of thoracic wall and inspiratory muscles improved. As a consequence dyspnea and quality of life improved. In this chapter we develop more widely how these different interventions may influenced or not in relieve dyspnea.

KEYWORDS

Dyspnea, oxygen, non invasive mechanical ventilation, lung volume reduction surgery.

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