Endoscopic Lung Volume Reduction Using Endobronchial Valves in Patients with Severe Emphysema and Very Low FEV1
| العنوان: | Endoscopic Lung Volume Reduction Using Endobronchial Valves in Patients with Severe Emphysema and Very Low FEV1 |
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| المؤلفون: | Frank Langer, Robert Bals, Daniela Leppert, Sebastian Fähndrich, Heinrike Wilkens, Anna J Höink, Philipp M. Lepper, Thomas P Graeter, Peter Minko, Franziska C. Trudzinski |
| المصدر: | Respiration. 92:258-265 |
| بيانات النشر: | S. Karger AG, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, Retrospective cohort study, Atelectasis, respiratory system, medicine.disease, respiratory tract diseases, Surgery, Chest tube, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Pneumothorax, DLCO, Diffusing capacity, Internal medicine, medicine, Cardiology, Lung volumes, 030212 general & internal medicine, Adverse effect, business |
| الوصف: | Background: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. Objectives: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. Methods: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred., and low DLCO who were treated by eLVR with endobronchial valves (EBV) between June 2012 and January 2015. Pre- and postinterventional lung function parameters, the 6-min walking test (6-MWT) distance, adverse events, and follow-up were recorded. Results: In 20 patients, there was an overall improvement in lung function with an increase in FEV1 (16.97-21.03% of pred.) and a decrease in residual volume (322-270% of pred.) and total lung capacity (144-129.06% of pred.). The 6-MWT distance improved (from 239 ± 77 to 267± 97 m overall, and from 184 ± 50 to 237 ± 101 m if patients developed an atelectasis of the target lobe). Pneumothorax occurred in 5 of the 20 patients (25%). 30-day mortality was 0%, and all patients survived to discharge. Conclusions: The patients benefitted moderately from EBV treatment despite an initially low FEV1. Some patients improved remarkably. EBV treatment in patients with an FEV1 ≤20% of pred. is generally feasible and safe. The greatest risk is pneumothorax with prolonged chest tube duration. |
| تدمد: | 1423-0356 0025-7931 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::4fe44a4c3c9618e1305e63dafba79bceTest https://doi.org/10.1159/000448761Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi...........4fe44a4c3c9618e1305e63dafba79bce |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14230356 00257931 |
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