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Efficacy of bronchoscopic lung volume reduction by endobronchial valves in patients with heterogeneous emphysema: report on the first Asian cases.

Park TS, Hong Y, Lee JS, Lee SM, Seo JB, Oh YM, Lee SD, Lee SW - J. Korean Med. Sci. (2014)

Bottom Line: Six patients showed clinical improvement after 1 month.Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026).Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Although many patients with severe emphysema have benefited from bronchoscopic lung volume reduction (BLVR) worldwide, experience of BLVR in Asian emphysema patients is scarce. Between July 2012 and March 2013, seven patients with advanced heterogeneous emphysema underwent BLVR in the Asan Medical Center. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1 sec [FEV1], 0.59 L [19.0 % predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into the target lobe which was most hyperinflated and least perfused, and had no collateral ventilation with other lobes. Six patients showed clinical improvement after 1 month. Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026). The median FEV1 increased from 0.59 to 0.89 L (51%; P = 0.028) and the median 6MWD increased from 195 to 252 m (29.2%; P = 0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events. BLVR is effective in Asian advanced emphysema patients, with noted clinical improvements in lung function and exercise capacity.

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Related in: MedlinePlus

Forced expiratory volume in 1 sec (A) and 6-min walk distance (B) at baseline and 1 month after the procedure (Data for patient No. 3 is at 3 months because he developed a pneumothorax 2 days after the procedure and had a tube thoracostomy for 1 month). Symbols represent individual patients. Bars are median values.
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Figure 1: Forced expiratory volume in 1 sec (A) and 6-min walk distance (B) at baseline and 1 month after the procedure (Data for patient No. 3 is at 3 months because he developed a pneumothorax 2 days after the procedure and had a tube thoracostomy for 1 month). Symbols represent individual patients. Bars are median values.

Mentions: Subsegmental linear atelectasis of the target lobe and expansion of other lobes were observed shortly after BLVR in most patients. The clinical efficacy of the procedure at 1 month post-procedure is shown in Table 4 and Fig. 1. Among seven patients, six patients showed clinical improvement with no clinical improvement seen in patient No 4.


Efficacy of bronchoscopic lung volume reduction by endobronchial valves in patients with heterogeneous emphysema: report on the first Asian cases.

Park TS, Hong Y, Lee JS, Lee SM, Seo JB, Oh YM, Lee SD, Lee SW - J. Korean Med. Sci. (2014)

Forced expiratory volume in 1 sec (A) and 6-min walk distance (B) at baseline and 1 month after the procedure (Data for patient No. 3 is at 3 months because he developed a pneumothorax 2 days after the procedure and had a tube thoracostomy for 1 month). Symbols represent individual patients. Bars are median values.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214942&req=5

Figure 1: Forced expiratory volume in 1 sec (A) and 6-min walk distance (B) at baseline and 1 month after the procedure (Data for patient No. 3 is at 3 months because he developed a pneumothorax 2 days after the procedure and had a tube thoracostomy for 1 month). Symbols represent individual patients. Bars are median values.
Mentions: Subsegmental linear atelectasis of the target lobe and expansion of other lobes were observed shortly after BLVR in most patients. The clinical efficacy of the procedure at 1 month post-procedure is shown in Table 4 and Fig. 1. Among seven patients, six patients showed clinical improvement with no clinical improvement seen in patient No 4.

Bottom Line: Six patients showed clinical improvement after 1 month.Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026).Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Although many patients with severe emphysema have benefited from bronchoscopic lung volume reduction (BLVR) worldwide, experience of BLVR in Asian emphysema patients is scarce. Between July 2012 and March 2013, seven patients with advanced heterogeneous emphysema underwent BLVR in the Asan Medical Center. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1 sec [FEV1], 0.59 L [19.0 % predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into the target lobe which was most hyperinflated and least perfused, and had no collateral ventilation with other lobes. Six patients showed clinical improvement after 1 month. Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026). The median FEV1 increased from 0.59 to 0.89 L (51%; P = 0.028) and the median 6MWD increased from 195 to 252 m (29.2%; P = 0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events. BLVR is effective in Asian advanced emphysema patients, with noted clinical improvements in lung function and exercise capacity.

Show MeSH
Related in: MedlinePlus