scholarly journals Update on Nonsurgical Lung Volume Reduction Procedures

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
J. Alberto Neder ◽  
Denis E. O’Donnell
Keyword(s):  
Lung Volume ◽  
Pulmonary Function Tests ◽  
Cardiopulmonary Exercise Testing ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Lung Deflation ◽  
Airway Stents ◽  
Canadian Research ◽  
Ventilation And Perfusion ◽  
Collateral Ventilation

There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures. Pre-LVRS or ELVR assessment should ideally include cardiological evaluation, high resolution CT scan, ventilation and perfusion scintigraphy, full pulmonary function tests, and cardiopulmonary exercise testing. ELVR procedures are currently available in selected Canadian research centers as part of ethically approved clinical trials. If a decision is made to offer an ELVR procedure, one-way valves are the first option in the presence of complete lobar exclusion and no significant collateral ventilation. When the fissure is not complete, when collateral ventilation is evident in heterogeneous emphysema or when emphysema is homogeneous, coil implants or BioLVR (in that order) are the next logical alternatives.

scholarly journals Lung Volume Reduction Surgery in Patients with Heterogenous Emphysema: Selecting Perspective

2019 ◽  
Vol 7 (24) ◽  
pp. 4389-4392
Author(s):  
Nguyen Truong Giang ◽  
Trung Nguyen Ngoc ◽  
Nguyen Van Nam ◽  
Nguyen Viet Nhung ◽  
Ta Ba Thang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Function Tests ◽  
Volume Reduction ◽  
Military Hospital ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Function Tests ◽  
Significant Difference ◽  
Preoperative Factor

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.

scholarly journals Predicting Atelectasis by Assessment of Collateral Ventilation prior to Endobronchial Lung Volume Reduction: A Feasibility Study

Respiration ◽  
2010 ◽  
Vol 80 (5) ◽  
pp. 419-425 ◽  
Author(s):  
D. Gompelmann ◽  
R. Eberhardt ◽  
G. Michaud ◽  
A. Ernst ◽  
F.J.F. Herth
Keyword(s):  
Feasibility Study ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Collateral Ventilation

scholarly journals IMPROVED ALGORITHM TO MEASURE COLLATERAL VENTILATION WITH CHARTIS FOR BRONCHOSCOPIC LUNG VOLUME REDUCTION PROCEDURES

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1876
Author(s):  
T. David Koster ◽  
Karin Klooster ◽  
Hallie McNamara ◽  
Narinder SHARGILL ◽  
Sri Radhakrishnan ◽  
...  
Keyword(s):  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Collateral Ventilation ◽  
Improved Algorithm

Changes in ventilation and perfusion following lower lobe endoscopic lung volume reduction (ELVR) with endobronchial valves in severe COPD

2019 ◽  
Vol 13 (7) ◽  
pp. 453-459
Author(s):  
Li Yang ◽  
Kelvin Hsu ◽  
Jonathan P. Williamson ◽  
Matthew J. Peters ◽  
Kevin Ho‐Shon ◽  
...  
Keyword(s):  
Lung Volume ◽  
Lower Lobe ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Ventilation And Perfusion ◽  
Severe Copd

scholarly journals An adjusted and time-saving method to measure collateral ventilation with Chartis

2021 ◽  
pp. 00191-2021
Author(s):  
T. David Koster ◽  
Karin Klooster ◽  
Hallie McNamara ◽  
Narinder S. Shargill ◽  
Sri Radhakrishnan ◽  
...  
Keyword(s):  
Lung Volume ◽  
Volume Reduction ◽  
Low Flow ◽  
Lung Volume Reduction ◽  
Time Saving ◽  
Treatment Target ◽  
Flow Rates ◽  
Physiological Assessment ◽  
New Feature ◽  
Collateral Ventilation

IntroductionBronchoscopic lung volume reduction with endobronchial valves is an important treatment option in selected patients with severe emphysema and absence of collateral ventilation (CV) in the treatment target lobe. The Chartis system provides an important physiological assessment of the presence or absence of collateral ventilation. We aimed to evaluate a new feature and determine whether low flow during a Chartis measurement is predictive for the absence of collateral ventilation, and whether this allows for a procedure to be shortened by earlier terminating the Chartis measurement. This is measured with the “Volume Trend for the previous 20 s” (VT20).MethodsWe retrospectively evaluated 249 Chartis assessments of patients scheduled for bronchoscopic lung volume reduction procedures. The VT20 was calculated, and several thresholds were compared between patients with collateral ventilation (CV positive) and without collateral ventilation (CV negative).Results100% of the CV negative patients reached a threshold of VT20 ≤6 mL, whereas all CV positive patients reached a VT20 ≥7 mL. The median “time saved” between VT20=6 mL and end of assessment was 60 s (range 5 to 354 s).ConclusionThe threshold of VT20 ≤6 mL is a reliable method to exclude the presence of collateral ventilation when air flow rates are low and can therefore reduce bronchoscopic lung volume procedure times.

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