The influence of a lung volume reduction with intrabronchial valves on the quality of life of patients with heterogeneous emphysema — a prospective study

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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Quality of life and lung volume reduction surgery

American Journal of Critical Care ◽

10.4037/ajcc1999.8.6.359 ◽

1999 ◽

Vol 8 (6) ◽

pp. 359-360

Author(s):

JL Faul ◽

RL Doyle ◽

AB Weinacker ◽

TA Raffin

Keyword(s):

Quality Of Life ◽

Lung Volume ◽

Volume Reduction ◽

Lung Volume Reduction Surgery ◽

Lung Volume Reduction

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Nursing care of the thoracoscopic lung volume reduction patient

American Journal of Critical Care ◽

10.4037/ajcc1996.5.6.412 ◽

1996 ◽

Vol 5 (6) ◽

pp. 412-419

Author(s):

KJ Vaca ◽

JF Osterloh ◽

CJ Daake ◽

NR Noedel

Keyword(s):

Quality Of Life ◽

Pulmonary Function ◽

Nursing Care ◽

Lung Volume ◽

Forced Expiratory Volume ◽

Minute Volume ◽

Volume Reduction ◽

Lung Volume Reduction ◽

Prolonged Air Leak

BACKGROUND: Several methods to surgically enhance pulmonary function and improve the quality of life in patients with bullous emphysema are currently being evaluated. One of these methods, lung volume reduction, is performed in patients with bullous emphysema that can no longer be well managed with medical therapy. OBJECTIVES: The focus of this article is to review bullectomy via unilateral thoracoscopy with an endoscopic stapler in the management of end-stage pulmonary emphysema, and to discuss nursing care of these patients. METHODS: An experimental study was used, including review of the literature and analysis of clinical experience using chi-square and t test analyses of pre- and postoperative variables. RESULTS: At 3-month follow-up there were significant improvements in forced expiratory volume in 1 second, forced vital capacity, minute volume ventilation, partial pressure of oxygen, residual volume, and 6-minute walk when pre- and postoperative parameters were compared. Operative mortality was 4%, with the most common complication being prolonged air leak, occurring in 30% of patients studied. CONCLUSIONS: There is now consistent preliminary information to support the concept that lung volume reduction improves pulmonary function and quality of life in a significant percentage of patients.

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