Implementing bronchoscopic lung volume reduction using one-way endobronchial valves in a Dutch university hospital, retrospective real-life outcomes at 3 months

2020 ◽  
Author(s):  
Rein Posthuma ◽  
Anouk Vaes ◽  
Kim Walraven ◽  
Geertjan Wesseling ◽  
Emiel Wouters ◽  
...  
Keyword(s):  
Lung Volume ◽  
Real Life ◽  
Volume Reduction ◽  
University Hospital ◽  
Life Outcomes ◽  
Lung Volume Reduction

scholarly journals Early Spirometry Following Bronchoscopic Lung Volume Reduction with Endobronchial Valves

2022 ◽  
Vol 11 (2) ◽  
pp. 440
Author(s):  
Pascal Bezel ◽  
Jasmin Wani ◽  
Gilles Wiederkehr ◽  
Christa Bodmer ◽  
Carolin Steinack ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Lung Volume ◽  
Small Sample Size ◽  
Treatment Success ◽  
Standard Operating Procedure ◽  
Small Sample ◽  
Volume Reduction ◽  
University Hospital ◽  
Lung Volume Reduction ◽  
Post Procedure

Bronchoscopic lung volume reduction (BLVR) by endobronchial valve (EBV) implantation has been shown to improve dyspnea, pulmonary function, exercise capacity, and quality of life in highly selected patients with severe emphysema and hyperinflation. The most frequent adverse event is a pneumothorax (PTX), occurring in approximately one-fifth of the cases due to intrathoracic volume shifts. The majority of these incidents are observed within 48 h post-procedure. However, the delayed occurrence of PTX after hospital discharge is a matter of concern. There is currently no approved concept for its prevention. Particularly, it is unknown whether and when respiratory manoeuvers such as spirometry post EBV treatment are feasible and safe. As per standard operating procedure at the University Hospital Zurich, early spirometry is scheduled after BLVR and prior to the discharge of the patient in order to monitor treatment success. The aim of our retrospective study was to investigate the feasibility and safety of early spirometry. In addition, we hypothesized that early spirometry could be useful to identify patients at risk for late PTX, which may occur after hospital discharge. All patients who underwent BLVR using EBVs between January 2018 and January 2020 at our hospital were enrolled in this study. After excluding 16 patients diagnosed post-procedure with PTX and four patients for other reasons, early spirometry was performed in 61 cases. There was neither a clinically relevant PTX during or after early spirometry nor a late PTX following hospital discharge. In conclusion, we found early spirometry, conducted not sooner than three days following EBV treatment, to be feasible and safe. Furthermore, early spirometry seems to be a useful predictor for successful BLVR, and it may help to decide whether a patient can be discharged. Given the small sample size and the retrospective design of our study, a prospective study that includes routine chest imaging after early spirometry to definitively exclude PTX is needed to recommend early spirometry as part of the standard protocol following EBV treatment.

scholarly journals Implementation of Bronchoscopic Lung Volume Reduction Using One-Way Endobronchial Valves: A Retrospective Single-Centre Cohort Study

Respiration ◽  
2021 ◽  
pp. 1-9
Author(s):  
Rein Posthuma ◽  
Anouk W. Vaes ◽  
Kim H. M. Walraven ◽  
Peyman Sardari Nia ◽  
Jan U. Schreiber ◽  
...  
Keyword(s):  
Lung Volume ◽  
Real Life ◽  
High Volume ◽  
Forced Expiratory Volume ◽  
Outcome Data ◽  
Volume Reduction ◽  
Small Subset ◽  
Lung Volume Reduction ◽  
Invasive Treatment

<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.

Lung Volume Reduction Surgery (Lvrs) For Emphysema: Initial Experience at the University Hospital Gasthuisberg

2000 ◽  
Vol 55 (3) ◽  
pp. 154-162 ◽  
Author(s):  
A.C. Verpeut ◽  
G.M. Verleden ◽  
D. Van Raemdonck ◽  
M. Decramer ◽  
T. Lerut ◽  
...  
Keyword(s):  
Lung Volume ◽  
Volume Reduction ◽  
University Hospital ◽  
Initial Experience ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
The University

Clinical and Quality of Life Outcomes After Lung Volume Reduction Surgery

2019 ◽  
Vol 108 (3) ◽  
pp. 866-872
Author(s):  
Benjamin Seadler ◽  
Sowmyanarayanan Thuppal ◽  
Nisha Rizvi ◽  
Stephen Markwell ◽  
Justin Sawyer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Volume ◽  
Volume Reduction ◽  
Life Outcomes ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Quality Of Life Outcomes

scholarly journals Real life results of coil treatment for bronchoscopic lung volume reduction in emphysema

2020 ◽  
Vol 68 (1) ◽  
pp. 17-24
Author(s):  
Demet TURAN ◽  
Deniz DOĞAN ◽  
Mustafa ÇÖRTÜK ◽  
Efsun Gonca UĞUR CHOUSEIN ◽  
Elif TANRIVERDİ ◽  
...  
Keyword(s):  
Lung Volume ◽  
Real Life ◽  
Volume Reduction ◽  
Lung Volume Reduction

Effects of endoscopic lung volume reduction on right ventricular myocardial function in patients with advanced emphysema

Pneumologie ◽  
2014 ◽  
Vol 68 (S 01) ◽  
Author(s):  
C Pizarro ◽  
R Schueler ◽  
C Hammerstingl ◽  
J Kreuz ◽  
U Juergens ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Lung Volume ◽  
Myocardial Function ◽  
Volume Reduction ◽  
Lung Volume Reduction

Volumetric and scintigraphic changes following endoscopic lung volume reduction

Pneumologie ◽  
2015 ◽  
Vol 69 (S 01) ◽  
Author(s):  
C Pizarro ◽  
H Ahmadzadehfar ◽  
M Essler ◽  
G Nickenig ◽  
D Skowasch
Keyword(s):  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction
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