PT  - JOURNAL ARTICLE
AU  - William McNulty
AU  - Zaid Zoumot
AU  - Samuel Kemp
AU  - Cielito Caneja
AU  - Pallav Shah
TI  - Bronchoscopic intrabullous autologous blood instillation (BIABI) for the treatment of severe bullous emphysema
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - 1776
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/1776.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/1776.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BackgroundGiant bullae contribute to breathlessness through hyperinflation, airflow obstruction and V/Q mismatch in emphysema. Surgical removal is the optimal treatment but has an associated morbidity.Aims and objectivesThis single arm, open label interventional trial aims to determine the effect of bronchoscopic intrabullous autologous blood instillation (BIABI) on lung volumes, spirometry, quality of life and 6 minute walk distance.MethodsSix patients who were considered not suitable or declined bullectomy were recruited. All patients had confirmed COPD with significant hyperinflation and a giant bulla. At day case bronchoscopy under conscious sedation, the giant bulla was cannulated with an extended working channel. 240mls of blood was instilled under fluoroscopy. Patients were reviewed at three months to assess lung function, quality of life and 6 minute walk distance.ResultsData is presented in the table as median (range). In this small group of patients there were clinically meaningful improvements in 6 minute walk distance, St George's Respiratory Questionnaire scores, spirometry and residual volume (RV). The number of patients is too small to allow statistical analysis.View this table:ConclusionsBIABI may offer functional and physiological improvements to patients with giant bullous emphysema. Further work is ongoing to determine the effect on quality of life, lung function and CT determined lung volumes in a larger group of patients.