Lung emphysema treated successfully using volume reduction with lung sealant (AeriSeal®)

Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 648-651
Author(s):  
Roger Fei ◽  
Hermann Ingerl ◽  
Martin Kohlhäufl ◽  
Keyword(s):  
Lung Function ◽  
Lung Volume ◽  
Volume Reduction ◽  
Secondary Outcome ◽  
Lung Volume Reduction ◽  
Peripheral Airways ◽  
Lung Emphysema ◽  
Before And After ◽  
Valve Implantation

AbstractEmphysema is a progressive and irreversible disease for which there is no cure to date. Endoscopic lung volume reduction with valve implantation or using lung sealant is a treatment option for patients with severe emphysema. A 60-year-old ex-smoker (80 pack years) referred to our center because of severe lung emphysema with progressive worsening of the obstructive ventilator pattern and clinical condition. By our patient we detected collateral channels by using the Chartis system®, which allow airflow into the target lobe and prevent atelectasis and significant lung volume reduction. Thus, we decided to treat the advanced emphysema of our patient with endoscopic volume reduction using lung sealant (AeriSeal®). The foam of lung sealant AeriSeal® is instilled into the peripheral airways and alveoli where it polymerizes and functions as tissue glue, forming a film of material on the lung surface that seals the target region to cause durable absorption atelectasis. Over a period of 16 weeks, the air within the sealed region was absorbed. The follow- up evaluation of this patient showed improved lung function (increased FEV 1, and a reduction of TLC and RV) with improved quality of life. Correlation between changes in primary and secondary outcome measures in the lung function parameters and 6- minute-walking test before and after the application of AeriSealant revealed significant reduction of hyperinflation and improvement both in the flow rates and physical capacity of our patient.

scholarly journals Severe Emphysema Treated by Endoscopic Bronchial Volume Reduction with Lung Sealant (AeriSeal)

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
R. F. Falkenstern-Ge ◽  
H. Ingerl ◽  
M. Kohlhäufl
Keyword(s):  
Lung Function ◽  
Volume Reduction ◽  
Secondary Outcome ◽  
Peripheral Oxygen Saturation ◽  
Target Region ◽  
Walking Test ◽  
Peripheral Airways ◽  
Lung Emphysema

Endoscopic lung volume reduction using lung sealant is a very new and innovative treatment option for patients with severe progressive and irreversible lung emphysema. A 55-year-old ex-smoker (60 pack years) referred to our center because of severe lung emphysema with progressive worsening of the obstructive ventilator pattern and clinical condition. We detected collateral channels of this patient by using the Chartis system. Therefore, we decided to treat the advanced emphysema of our patient with endoscopic volume reduction using lung sealant (AeriSeal). The foam of lung sealant AeriSeal is instilled into the peripheral airways and alveoli where it polymerizes and functions as tissue glue on the lung surface in order to seal the target region to cause durable irreversible absorption atelectasis. The follow-up evaluation 12 weeks later showed improved lung function (increased FEV 1/partial oxygen pressure/peripheral oxygen saturation and a reduction of TLC and RV) with improved quality of life. Correlation between changes in primary and secondary outcome measures in the lung function parameters and 6-minute-walking test before and 12 weeks after the application of lung sealant revealed significant reduction of hyperinflation and improvement both in the flow rates and in the physical capability of this patient.

scholarly journals Endoscopic lung volume reduction with endobronchial valves in very low DLCO patients: results from the German Registry (Lungenemphysemregister e.V.)

2020 ◽  
pp. 00449-2020
Author(s):  
Pavlina Lenga ◽  
Christoph Ruwwe-Glösenkamp ◽  
Christian Grah ◽  
Joachim Pfannschmidt ◽  
Jens Rückert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Exercise Capacity ◽  
Lung Volume ◽  
Forced Expiratory Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Lung Emphysema

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.

Correlation of Changes in Quality of Life After Lung Volume Reduction Surgery With Changes in Lung Function, Exercise, and Gas Exchange

CHEST Journal ◽  
2000 ◽  
Vol 118 (3) ◽  
pp. 728-735 ◽  
Author(s):  
Vadim Leyenson ◽  
Satoshi Furukawa ◽  
Anne Marie Kuzma ◽  
Francis Cordova ◽  
John Travaline ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Gas Exchange ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction

Improvements in Lung Function, Exercise, and Quality of Life in Hypercapnic COPD Patients After Lung Volume Reduction Surgery

CHEST Journal ◽  
1999 ◽  
Vol 115 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Gerald M. O’Brien ◽  
Satoshi Furukawa ◽  
Anne Marie Kuzma ◽  
Francis Cordova ◽  
Gerard J. Criner
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Copd Patients

Lung Volume Reduction Surgery for Emphysema: Correlation of CT and V/Q Imaging with Physiologic Mechanisms of Improvement in Lung Function

Radiology ◽  
2002 ◽  
Vol 222 (2) ◽  
pp. 491-498 ◽  
Author(s):  
Andetta R. Hunsaker ◽  
Edward P. Ingenito ◽  
John J. Reilly ◽  
Philip Costello
Keyword(s):  
Lung Function ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction

scholarly journals Lung Function 4 Years After Lung Volume Reduction Surgery for Emphysema

CHEST Journal ◽  
1999 ◽  
Vol 116 (6) ◽  
pp. 1608-1615 ◽  
Author(s):  
Arthur F. Gelb ◽  
Robert J. Mc Kenna ◽  
Matthew Brenner ◽  
Mark J. Schein ◽  
Noe Zamel ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction

scholarly journals Delayed results of lung volume reduction surgery in heterogeneous lung emphysema

2005 ◽  
pp. 84-86
Author(s):  
P. Wex ◽  
V. Haas ◽  
E. Utta
Keyword(s):  
Lung Volume ◽  
Oxygen Therapy ◽  
Postoperative Mortality ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Walk Distance ◽  
Lung Emphysema ◽  
Blood Gas Parameters

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.

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