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

A New-Designed Lung-Bending Device for Bronchoscopic Lung Volume Reduction of Severe Emphysema: A Feasibility Study in Pigs

Respiration ◽  
2019 ◽  
Vol 97 (5) ◽  
pp. 444-450
Author(s):  
Yan Hu ◽  
Yuan Cheng ◽  
Hong Zhang ◽  
Anning Li ◽  
Siyi Li ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Severe Emphysema

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.

Validation and pilot clinical study of a new bronchoscopic method to measure collateral ventilation before endobronchial lung volume reduction

2009 ◽  
Vol 106 (3) ◽  
pp. 774-783 ◽  
Author(s):  
Nikolai Aljuri ◽  
Lutz Freitag
Keyword(s):  
Lung Volume ◽  
Clinical Performance ◽  
Human Subjects ◽  
Compartment Model ◽  
Volume Reduction ◽  
Spontaneous Respiration ◽  
Lung Volume Reduction ◽  
Laboratory Setup ◽  
Benchtop Model ◽  
Collateral Ventilation

Endobronchial lung volume reduction (ELVR) may be helpful in a selected group of patients with advanced stages of emphysema. However, collateral ventilation (CV) from adjacent lobes through collateral channels often prevents target lobe atelectasis, which presumably mediates clinical responses after ELVR. With the goal of identifying patients who are more or less likely to benefit, we propose endobronchial CV assessment (ECVA), a novel catheter-based endobronchial approach, to quantitatively determine the resistance of collateral channels ( R coll). ECVA relies on the measurement of spontaneous airflow from the sealed and isolated target compartment during spontaneous respiration in an awake subject, thereby providing a direct, simple, and minimally invasive method of assessing R coll in lungs. In this study, we validated ECVA in a controlled laboratory setup and tested ECVA's clinical feasibility in 11 emphysematous human subjects undergoing ELVR treatment. To evaluate ECVA in a controlled laboratory setup with known CV levels, we built a benchtop model mimicking a simple one-compartment model of the lungs during temporary compartmental occlusion and spontaneous respiration, which could be adapted to hold restrictors of different sizes representing collateral airways, and applied ECVA to estimate the resistance of various benchtop model restrictors. We then rated ECVA's performance by direct comparison between estimated and actual restrictor resistance and found a correlation coefficient near one. To test ECVA's clinical performance, post-ELVR radiological assessments were made to determine the occurrence of atelectasis in the treated lobe, and interlobar R coll was estimated in the target lobe via ECVA pre-ELVR. ECVA could be completed in all patients with no adverse events, and a high R coll by ECVA predicted absorption atelectasis following ELVR ( P = 0.005). We believe that ECVA may be helpful to distinguish those patients with and without interlobar CV by identifying the critical value of R coll above which atelectasis is likely to occur.

Sign in / Sign up

Export Citation Format

Share Document