scholarly journals Effectiveness of Endobronchial Coil Treatment for Lung Volume Reduction in Patients with Severe Heterogeneous Emphysema and Bilateral Incomplete Fissures: A Six-Month Follow-Up

Respiration ◽  
2014 ◽  
Vol 88 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Konstantina Kontogianni ◽  
Vasiliki Gerovasili ◽  
Daniela Gompelmann ◽  
Maren Schuhmann ◽  
Claus Peter Heussel ◽  
...  
2005 ◽  
pp. 84-86
Author(s):  
P. Wex ◽  
V. Haas ◽  
E. Utta

The aim of the study was to search delayed results and to characterize patients with heterogeneous emphysema which do not improve their quality of life after lung volume reduction surgery. Retrospective analysis was done based on medical history reports from July, 1994, to January, 1998. The surgical lung volume reduction was performed in 81 patients (45 males and 13 females, the average age was 61.9 yrs). Postoperative mortality was 6.9 % (4 patients). Twenty-three patients died within 5 yrs after the intervention; their mean follow-up period was 33.3 months. The average follow-up period was 54.3 months. Functional parameters for patients survived 3 to 5 yrs were: FEV1 50 ± 23.8 %, RV 35.6 ± 29.1 %, RV / TLC 12.3 ± 12 %, the 6-min walk distance was 96.7 ± 62 m. The total 5-year survival was 63.8 %, the survival for the patients having FEV1> 30 % was 83.8 % and that for the patients with FEV1 < 30 % was 50 %. Age and lung function parameters did not differ in survivors and died patients. On the contrary, differences in the blood gas parameters, oxygen therapy time and 6-min walk distance were significant between these groups. Some negative factors were revealed: predominant injury of the lower lung fields, FEV1 < 30 % pred., respiratory failure (PaCO2 ≥ 48 mm Hg), oxygen therapy longer than 6 months, the 6-min walk distance shorter than 80 m.


Respirology ◽  
2014 ◽  
Vol 20 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Jorine E. Hartman ◽  
Karin Klooster ◽  
Kiki Gortzak ◽  
Nick H.T. Hacken ◽  
Dirk‐Jan Slebos

Author(s):  
Valentina Luzzi ◽  
Margherita Innocenti ◽  
Sofia Romani ◽  
Fausto Leoncini ◽  
Michela Bezzi

Respiration ◽  
2021 ◽  
pp. 1-9
Author(s):  
Rein Posthuma ◽  
Anouk W. Vaes ◽  
Kim H. M. Walraven ◽  
Peyman Sardari Nia ◽  
Jan U. Schreiber ◽  
...  

<b><i>Background:</i></b> Bronchoscopic lung volume reduction (BLVR) using 1-way endobronchial valves (EBV) has become a guideline treatment in patients with advanced emphysema. Evidence from this minimally invasive treatment derives mainly from well-designed controlled trials conducted in high-volume specialized intervention centres. Little is known about real-life outcome data in hospitals setting up this novel treatment and which favourable conditions are required for a continuous successful program. <b><i>Objectives:</i></b> In this study, we aim to evaluate the eligibility rate for BLVR and whether the implementation of BLVR in our academic hospital is feasible and yields clinically significant outcomes. <b><i>Method:</i></b> A retrospective evaluation of patients treated with EBV between January 2016 and August 2019 was conducted. COPD assessment test (CAT), forced expiratory volume in 1 s (FEV<sub>1</sub>), residual volume (RV), and 6-min walking test (6MWT) were measured at baseline and 3 months after intervention. Paired sample <i>t</i> tests were performed to compare means before and after intervention. <b><i>Results:</i></b> Of 350 subjects screened, 283 (81%) were not suitable for intervention mostly due to lack of a target lobe. The remaining 67 subjects (19%) underwent bronchoscopic assessment, and if suitable, valves were placed in the same session. In total, 55 subjects (16%) were treated with EBV of which 10 did not have complete follow-up: 6 subjects had their valves removed because of severe pneumothorax (<i>n</i> = 2) or lack of benefit (<i>n</i> = 4) and the remaining 4 had missing follow-up data. Finally, 45 patients had complete follow-up at 3 months and showed an average change ± SD in CAT −4 ± 6 points, FEV<sub>1</sub> +190 ± 140 mL, RV −770 ± 790 mL, and +37 ± 65 m on the 6MWT (all <i>p</i> &#x3c; 0.001). After 1-year follow-up, 34 (76%) subjects had their EBV in situ. <b><i>Conclusion:</i></b> Implementing BLVR with EBV is feasible and effective. Only 16% of screened patients were eligible, indicating that this intervention is only applicable in a small subset of highly selected subjects with advanced emphysema, and therefore a high volume of COPD patients is essential for a sustainable BLVR program.


2020 ◽  
pp. 00449-2020
Author(s):  
Pavlina Lenga ◽  
Christoph Ruwwe-Glösenkamp ◽  
Christian Grah ◽  
Joachim Pfannschmidt ◽  
Jens Rückert ◽  
...  

BackgroundEndoscopic lung volume reduction (ELVR) with valves has been suggested to be the key strategy for patients with severe emphysema and concomitant low diffusion capacity of the lung for carbon monoxide (DLCO). However, robust evidence is still missing. We therefore aim to compare clinical outcomes in relation to DLCO for patients treated with ELVR.MethodsWe assessed DLCO at baseline and 3-months follow-up and compared pre- and postprocedural pulmonary function test (PFT), quality of life, exercise capacity and adverse events. This is a retrospective subanalysis of prospectively collected data from the German Lung Emphysema Registry.Results121 patients treated with ELVR were analysed. 34 patients with a DLCO ≤20% and 87 patients with a DLCO >20% showed similar baseline characteristics. After ELVR, there was a decrease of residual volume (both p<0.001 to baseline) in both groups and both demonstrated better quality of life (p<0.01 to baseline). Forced expiratory volume in 1 s (FEV1) improved significantly only in patients with a DLCO >20% (p<0.001 to baseline). Exercise capacity remained almost unchanged in both groups (p=0.3). The most frequent complication for both groups was a pneumothorax (DLCO ≤20%: 17.6% versus DLCO >20%: 16.1%; p=0.728). However, there were no significant differences in other adverse events between both groups.ConclusionsELVR improves lung function as well as quality of life in patients with DLCO >20% and DLCO ≤20%. Adverse events did not differ between groups. Therefore, ELVR should be considered as a treatment option, even in patients with a very low DLCO.


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